Source: Annual Congress 2006 - Sarcoidosis
Disease area: Thoracic oncology

Abstract

[Background/Purposes]
Since the assessment of noncaseating granulomas remains essential for the confirmation of the diagnosis of sarcoidosis, a positive histologic diagnosis is frequently required in the patients suspected of having this disorder. Stage I disease is most common form of this disease. However, it is frequently difficult to obtain the histologic confirmation in such cases. Therefore, we performed transbronchial lymph node aspiration biopsy (TBNB) using flexible bronchoscope in patients who showed Stage I disease, which has especially prominent mediastinal lymphadenopathy. We investigated the efficacy and safety of this method.
[Subjects/Methods]
We examined consecutive 21 patients, 5 men and 16 women, who were suspected as a diagnosis of sarcoidosis clinically between April 1999 and January 2006. The mean age was 67 years (range 27-82). All 21 patients have Stage I disease. Chest CT scan revealed an enlargement of the mediastinal lymph node in all subjects. TBNB was performed by means of Endosonopsy ®(Hakko) using a biopsy needle (21 G x 25 mm), and specimens were taken from the subcarinal lymph node in 20 patients.
[Results]
The tissue collected from each subject was sufficient in quantity and quality for a pathological diagnosis, containing a noncaseating granuloma in the absence of an identifiable infectious process, foreign body, or allergic tissue reaction. All 21 patients were pathologically confirmed as having sarcoidosis. They showed no complications except a small bleeding at the puncture sites.
[Conclusions]
Based on these data, we conclude that TBNB is a simple, safe and effective examination method to diagnose sarcoidosis in patients with mediastinal lymph node enlargement.

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Citations should be made in the following way:
N. Nanki, Y. Yamaji, K. Miyatani (Kanonji, Japan). Flexible taransbronchial needle lymph node biopsy for the diagnosis of sarcoidosis. Eur Respir J 2006; 28: Suppl. 50, 3129

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