title: Lymph node characteristics of sarcoidosis with endobronchial ultrasound.
abstract: BACKGROUND
  Sonographic features of lymph nodes on endobronchial ultrasound (EBUS) have been shown to be useful in prediction of malignancy in mediastinum and hilum. The aim of this study was to assess the utility of morphologic features of mediastinal and/or hilar lymph nodes obtained by EBUS in patients with sarcoidosis.
  
  
  METHODS
  We retrospectively reviewed the records of 224 patients with mediastinal/hilar lymph node enlargements who underwent EBUS for diagnostic purpose. The lymph nodes were characterized based on the EBUS images as follows: (1) Size; based on short-axis dimension, <1 cm or ≥1 cm, (2) shape; oval or round, (3) margin; distinct or indistinct, (4) echogenicity; homogeneous or heterogeneous, (5) presence or absence of central hilar structure, and (6) presence or absence of granular (sandpaper) appearance.
  
  
  RESULTS
  One hundred (24.4%) nodes exhibited indistinct margins while 309 (75.6%) had distinct margins. One hundred and ninety nine (48.7%) nodes were characterized as homogeneous, and 210 (51.3%) nodes as heterogeneous. Granular appearance was observed in 130 (31.8%) lymph nodes. The presence of granules in lymph nodes on EBUS had the highest specificity (99.3%) for the diagnosis of sarcoidosis. Logistic regression analysis revealed the finding of distinct margin alone as an independent predictive factor for the diagnosis of sarcoidosis.
  
  
  CONCLUSIONS
  The presence of granular appearance in lymph nodes by EBUS had the highest specificity (99.3%) for the diagnosis of sarcoidosis. Lymph nodes having distinct margins tend to suggest sarcoidosis.
authors.affiliation: Department of Pulmonary Medicine, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ozgul
authors.affiliation: Department of Pulmonary Medicine, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Erdoğan
authors.initials: E
authors.lastname: Cetinkaya
authors.affiliation: Department of Pulmonary Medicine, Firat University, Faculty of Medicine, Elazig, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Kirkil
authors.affiliation: Department of Pulmonary Medicine, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Guler
authors.initials: G
authors.lastname: Ozgul
authors.affiliation: Department of Pulmonary Medicine, Faculty of Medicine, Karadeniz Technical University Trabzon, Kayseri, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Abul
authors.affiliation: Department of Pulmonary Medicine, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Acat
authors.affiliation: Department of Pulmonary Medicine, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Onaran
authors.affiliation: Department of Pathology, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
authors.forename: Halide Nur
authors.initials: HN
authors.lastname: Urer
authors.affiliation: Department of Pulmonary Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Tutar
authors.affiliation: Department of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota Minneapolis, MN, USA.
authors.forename: H Erhan
authors.initials: HE
authors.lastname: Dincer
keywords: Diagnosis; echoic features; endobronchial ultrasonography; sarcoidosis