PURPOSE: The aim of this study was to evaluate the diagnostic utility of transesophageal bronchoscopic ultrasound-guided needle aspiration using an ultrasound bronchoscope in patients with stage I/II sarcoidosis.
METHODS: Thirty-three patients suspected of having stage I/II sarcoidosis were included in this prospective study. Needle aspiration through the esophagus using an ultrasound bronchoscope was performed for hilar and/or mediastinal lymph nodes. The final diagnosis of sarcoidosis was based on clinicoradiological compatibility and pathological findings.
RESULTS: A total of 62 lymph nodes with the mean shortest diameter of 13.6 mm were examined. Of the 33 patients enrolled, 29 were given a final diagnosis of sarcoidosis. Four of the residual patients had other diseases (1 lung cancer, 1 tuberculosis, 2 non-specific lymphadenitis). Transesophageal bronchoscopic ultrasound-guided needle aspiration showed non-caseating epithelioid cell granuloma in 25 of 29 patients (86%) with the final diagnosis of sarcoidosis. No complications were observed.
CONCLUSIONS: Transesophageal bronchoscopic ultrasound-guided needle aspiration is feasible, safe and accurate for the diagnosis of stage I/II sarcoidosis.
CLINICAL IMPLICATIONS: This procedure may be a useful alternative to conventional transesophageal needle aspiration using an ultrasound endoscope or transbronchial needle aspiration using an ultrasound bronchoscope in the diagnosis of sarcoidosis.
DISCLOSURE: Masahide Oki: Fiduciary position (of any organization, association, society, etc, other than ACCP: Dr. Oki has received an honorarium for a lecture on EBUS-TBNA from Olympus, at the Annual Meeting of the Japan Society of Respiratory Endoscopy in May, 2010.
The following authors have nothing to disclose: Hideo Saka, Chiyoe Kitagawa, Yoshihito Kogure, Naohiko Murata, Misaki Ryuge, Takashi Adachi, Rie Tsuboi, Saori Oka, Shu Ichihara, Suzuko Moritani
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