Source: Annual Congress 2002 - Interstitial lung disease
Disease area: Thoracic oncology

Abstract

RATIONALE: In patients with the clinical suspicion of sarcoidosis and enlarged mediastinal lymph nodes it is often important to establish a tissue diagnosis. Tissue confirmation of sarcoidosis is not only mandatory before possible treatment, it is also critically important to rule out malignant disease, tuberculosis or malignant lymphoma. Mediastinal lymph nodes can be biopsied in a minimally invasive way by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) from the esophagus. AIM: of this study was to demonstrate that EUS guided biopsies of mediastinal lymph nodes could support the clinical suspicion of sarcoidosis and rule out other diseases. METHODS: 13 patients with the clinical suspicion of sarcoidosis and enlarged (>1 cm) mediastinal lymph nodes were included. Seven patients underwent a previous nondiagnostic bronchoscopy. RESULTS: in 11 patients (84%) EUS–FNA demonstrated epitheloid cell granuloma formation suggesting sarcoidosis. In one patient (8%) EUS-FNA showed epitheloid cell granuloma formation with necrosis suggesting tuberculosis; PCR for mycobacterium tuberculosis was negative, cultures are pending. EUS-FNA of the last patient revealed reactive lymph node tissue whereas mediastinoscopy and culture demonstrated mycobacterium tuberculosis. No complications occurred.
CONCLUSION: These results suggest that in patients with the clinical suspicion of sarcoidosis and enlarged mediastinal lymph nodes EUS-FNA is a valuable, safe and minimal invasive diagnostic tool to diagnose sarcoidosis.

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Citations should be made in the following way:
J. T. Annema, M. Veselic, K. F. Rabe (Leiden, The Netherlands). Diagnosing sarcoidosis by transesophageal endoscopic ultrasound guided fine needle aspiration. Eur Respir J 2002; 20: Suppl. 38, 3757

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