PURPOSE: The aim of this study was to compare the diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and transbronchial lung biopsy (TBLB) in patients with stage I/II sarcoidosis.
METHODS: A total of 62 patients with suspected stage I/II sarcoidosis were included in this prospective study. EBUS-TBNA was performed (2 lymph nodes, 2 needle passes for each lymph node), followed by TBLB (5 biopsies for plural lung segments) in the same setting. The final diagnosis of sarcoidosis was based on clinicoradiological compatibility and pathological findings.
RESULTS: EBUS-TBNA was performed in all 62 patients enrolled, while TBLB was performed in 60 patients, since the procedure was terminated in the middle of EBUS-TBNA because of a severe cough in one patient and at the initial attempt of TBLB because of moderate bleeding in another patient. Fifty-four patients were given a final diagnosis of sarcoidosis. Four of the residual patients had other diseases (2 tuberculosis, 1 lymphoma, 1 IgG4-related lymphadenopathy) and 4 were indefinite. The diagnostic yield of EBUS-TBNA and TBLB by showing non-caseating epithelioid cell granuloma was 94% (stage I, 97%; stage II, 88%) and 37% (stage I, 31%; stage II, 50%), respectively. The difference was statistically significant (p<0.001). One pneumothorax and 3 moderate bleeding cases resulted from TBLB.
CONCLUSION: EBUS-TBNA is accurate and safe for the diagnosis of stage I/II sarcoidosis. This procedure is a useful alternative to TBLB in patients suspected of having sarcoidosis.
CLINICAL IMPLICATIONS: EBUS-TBNA may be a useful alternative to TBLB in the diagnosis of stage I/II sarcoidosis.
DISCLOSURE: Masahide Oki, No Financial Disclosure Information; No Product/Research Disclosure Information