title: Diagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration compared with transbronchial and endobronchial biopsy for suspected sarcoidosis.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate and minimally invasive technique that has been shown to have excellent diagnostic yield in the investigation of mediastinal and hilar lymphadenopathy. There is, however, little evidence comparing this procedure to the traditional diagnostic approach of transbronchial lung (TBLB) and endobronchial (EB) biopsies combined with characteristic clinical and radiological features in sarcoidosis.
  
  
  OBJECTIVE
  To compare the diagnostic yield of EBUS-TBNA, TBLB and EB in patients with suspected sarcoidosis.
  
  
  METHODS
  Data from 40 consecutive patients with suspected sarcoidosis who underwent combined EBUS-TBNA with TBLB and EB biopsies were recorded.
  
  
  RESULTS
  A total of 37 patients was confirmed as sarcoidosis, and three had other diagnoses. There was no difference in diagnostic accuracy rates between EBUS-TBNA and TBLB for all stages of sarcoidosis (84% vs 78%, P= 0.77). Combined EBUS-TBNA and TBLB procedures yielded a diagnostic accuracy of 100%. There was a highly significant difference in diagnostic accuracy between EBUS-TBNA and EB in stage I (80% vs 27%) (P < 0.01) and stage II disease (86% vs 27%) (P < 0.01). Similarly, a highly significant difference in diagnostic accuracy was seen between TBLB and EB (P < 0.01). No adverse events occurred.
  
  
  CONCLUSIONS
  Endobronchial ultrasound-guided transbronchial needle aspiration alone has a high diagnostic yield with a very low complication rate for patients with suspected sarcoidosis.
authors.affiliation: Department of Thoracic Medicine, St Vincent's Hospital, University of New South Wales, Sydney, New South Wales, Australia. mplit@stvincents.com.au
authors.forename: M
authors.initials: M
authors.lastname: Plit
authors.forename: R
authors.initials: R
authors.lastname: Pearson
authors.forename: A
authors.initials: A
authors.lastname: Havryk
authors.forename: J
authors.initials: J
authors.lastname: Da Costa
authors.forename: C
authors.initials: C
authors.lastname: Chang
authors.forename: A R
authors.initials: AR
authors.lastname: Glanville
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D017565:Sarcoidosis, Pulmonary / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult