Sarcoidosis is a relatively common interstitial lung disease. Case series have suggested racial differences in radiology findings at presentation and bronchoscopically obtained lung biopsies for tissue diagnosis. This study aims to determine what racial differences exist in chest radiology and in bronchoscopically obtained lung biopsies yields. Multivariate analysis was performed to determine which radiographic findings predict a higher yield of bronchoscopy for tissue diagnosis.
Retrospective review of 270 bronchoscopies performed for suspected sarcoidosis over 13 years. Chi-square analysis was used for racial comparisons of radiology findings and biopsy yields. Multivariate analysis was performed to determine which radiographic patterns and biopsies predict a successful bronchoscopic evaluation for sarcoidosis.
In African-Americans, the yield for endobronchial biopsy alone was 92% (11/12), for transbronchial biopsy 84% (104/123), and combination transbronchial and endobronchial biopsy was 84% (52/62). In Caucasians the yields were 60% (3/5), 71% (30/42), and 85% (22/26) respectively. There were no racial differences in diagnostic yield. Radiographically, Caucasians are more likely to have a normal chest x-ray (10% vs. 2%) (p=0.01) and to have a CT chest performed (62% vs. 42%) (p=0.0034). There were no racial differences on chest x-ray or computed tomography with regards to interstitial or alveolar infiltrates, adenopathy, and nodular pattern. There were gender dependent predictors of diagnostic yield. Males that had an endobronchial biopsy performed or had a chest x-ray pattern of interstitial infiltrates were more likely have a positive yield on bronchoscopy, odds ratios 3.1 (CI 1.04-9.2), 4.3 (CI 1.4-13.6).
The diagnostic yield, when transbronchial and endobronchial biopsies were obtained, was 85% in African-Americans and Caucasians. There were no racial differences in biopsy yield or radiographic patterns. Endobronchial biopsy and interstitial infiltrates added significant diagnostic yield when performed in males.
Race is not an independent predictor of bronchoscopic biopsy yields. Endobronchial biopsies should be performed in males who have bronchoscopy performed for tissue diagnosis of sarcoidosis.
R.R. Burke, None.