Transbronchial needle aspiration improves the diagnostic yield of bronchoscopy in sarcoidosis.
OBJECTIVE
Transbronchial needle aspiration (TBNA) is a minimally invasive bronchoscopic procedure that allows sampling of hilar and mediastinal lymph nodes in close contact with the airways. We undertook this study to assess the value of TBNA in the diagnosis of sarcoidosis manifesting with intrathoracic lymphadenopathies (stages I and II), and to compare its yield with that of transbronchial lung biopsy (TBLB).


METHODS
The results of bronchoscopy with combined TBNA and TBLB in 32 patients with stage I or II sarcoidosis were retrospectively analyzed.


RESULTS
Sensitivity was 65.6% for TBNA (stage I, 82.3 %; stage II, 46.6%), and 62.5% for TBLB (stage 1, 52.9%; stage II, 73.3%). The combination of the two methods was associated with the highest diagnostic yield (93.7% overall sensitivity), and allowed significantly better results over both TBNA alone (93.7% vs 65.6%; p = 0.011) and TBLB alone (93.7% vs 62.5%; p = 0.005).


CONCLUSIONS
The results of our study suggest that a diagnostic approach combining TBNA and TBLB is safe and effective in the setting of stage I and II sarcoidosis. It also confirmed the value of TBNA, with excellent diagnostic yields especially in stage I of the disease.
Unit of Thoracic Endoscopy, Maggiore Hospital, Bologna, Italy.
Rocco
R
Trisolini
Luigi
L
Lazzari Agli
Alessandra
A
Cancellieri
Venerino
V
Poletti
Piero
P
Candoli
Daniela
D
Paioli
Marco
M
Alifano
Carmine
C
Tinelli
Marco
M
Patelli
D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000209:etiology / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000150:complications / Q000473:pathology*; D012680:Sensitivity and Specificity