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KMID : 0383820100680050267
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Tuberculosis and Respiratory Diseases
2010 Volume.68 No. 5 p.267 ~ p.272
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Pulmonary Sarcoidosis Diagnosed by Endobronchial Ultrasound Fine Needle Aspiration
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Kim Wong-Young
Chang You-Jin
Lyu Ji-Won
Park Young-Soo
Jang Se-Jin
Song Jin-Woo
Oh Yeon-Mok
Shim Tae-Sun
Lee Sang-Do
Kim Woo-Sung
Kim Dong-Soon
Choi Chang-Min
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Abstract
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Background: Pulmonary sarcoidosis often involves mediastinal or hilar lymph nodes in the lung parenchyma. Mediastinoscopy is the gold standard for diagnosis, but it is invasive and expensive. Transbronchial needle aspiration using conventional bronchoscope is less invasive than mediastinoscopy, but its diagnostic accuracy is in question due to the blind approach to targeting lymph nodes. Transbronchial needle aspiration (TBNA) via endobronchial ultrasound (EBUS) has high diagnostic value due to direct visualization of lymph nodes and to its relatively safeness. The purpose of this study was to assess the usefulness of EBUS-TBNA in the diagnosis of pulmonary sarcoidosis.
Materials and Methods: Twenty-five patients with symptoms of sarcoidosis were enrolled into this study. Core tissue was obtained for a definitive diagnosis. Endobronchial biopsy, transbronchial lung biopsy, and bronchoalveolar lavage were performed to verify diagnosis. For patients without a confirmed diagnosis after the above procedures were performed, the additional procedures of mediastinoscopy or video-associated thoracoscopic surgery were performed to confirm a final diagnosis.
Results: A total 25 EBUS procedures were done and 50 lymph nodes were aspirated. Thirty-three (37) out of 50 lymph nodes were consistent with non-caseating granuloma, confirming sarcoidosis as the final diagnosis. Sarcoidosis was the final diagnosis for all 25 patients, and 21 required EBUS-TBNA for a final diagnosis. There were no complications associated with the procedure.
Conclusion: EBUS-TBNA is already a well-known procedure for diagnosing mediastinal or hilar lymphadenopathy. We used EBUS-TBNA for the diagnosis of pulmonary sarcoidosis and our results showed 84% diagnostic accuracy and no complications related to the procedure. EBUS-TBNA is a reliable and practical diagnostic modality in the diagnosis of pulmonary sarcoidosis.
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KEYWORD
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Bronchoscopy, Biopsy, Fine-Needle, Sarcoidosis, Pulmonary
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