Diagnostic Value of Endobronchial Ultrasonography in Sarcoidosis and Factors Associated with Diagnosis

Objective: The aim of this study was to investigate the diagnostic value of endobronchial ultrasonography (EBUS) and factors associated with diagnosis in patients with lung sarcoidosis. Methods: In this prospective study, EBUS transbronchial needle aspiration (TBNA) was performed for patients with a clinical and radiological suspicion of pulmonary sarcoidosis with enlarged hilar/mediastinal lymph nodes detected on a computerized tomography scan of the chest between January 2014 and September 2015. Results: During the study period, 107 patients underwent EBUS-TBNA and 1 patient underwent transesophageal endoscopic ultrasonography with fine needle aspiration (EUS-FNA). Four cases determined to be non-sarcoidosis (tuberculosis) were excluded from the study. Of the 104 cases definitively diagnosed as sarcoidosis, 28.8% were male patients and 71.2% were female, with a mean age of 44.3±13.1 years. A total of 92.3% of the patients (n=96) were diagnosed with EBUS-TBNA and 1% (n=1) was diagnosed based on EUS-FNA results. EBUS was nondiagnostic in 7 patients and sarcoidosis was diagnosed by mediastinoscopy in 6 patients and by right supraclavicular lymph node biopsy in 1 patient. The sensitivity of EBUS-TBNA was 92.3%, with a specificity of 100%. Conclusion: EBUS-TBNA has a high sensitivity and specificity for demonstrating granulomatous inflammation in cases of suspected sarcoidosis. Given the high diagnostic rate of EBUS-TBNA, additional invasive procedures may be unnecessary.

Sarkoidozda Endobronşiyal Ultrasonografinin Tanı Değeri ve Tanıyla İlişkili Faktörler

Amaç: Çalışmamızda akciğer sarkoidozu olan olgularda endobronşiyal ultrasonografinin (EBUS) tanı değerini ve tanıyla ilişkili faktörleri araştırmayı amaçladık. Gereç ve Yöntem: İleriye yönelik olarak planlanan bu çalışmada, Ocak 2014 ile Eylül 2015 tarihleri arasında polikliniğimize başvuran, klinik ve radyolojik olarak akciğer sarkoidozu düşünülen, toraks bilgisayarlı tomografisinde (BT) büyümüş hiler/mediastinal lenf bezi saptanarak EBUS transbronşiyal iğne aspirasyonu (TBİA) yapılan olguları inceledik. Bulgular: Çalışma periyodu içersinde 107 hastaya EBUS-TBİA, bir hastaya endoskopik ultrason eşliğinde transözofagial iğne aspirasyonu (EUS-TÖİA) yapıldı. Sarkoidoz dışı tanı (tüberküloz) alan dört hasta çalışmadan çıkarıldı. Sarkoidoz tanısı alan 104 hastanın %28.8’ini erkek, %71.2’sini kadın hastalar oluşturmaktaydı. Yaş ortalaması 44.3±13.1 yıl saptandı. Yüz dört hastanın 96’sına (%92.3) EBUS-TBİA, bir hastaya (%1) EUS-TÖİA ile sarkoidoz tanısı kondu. Tanı elde edilemeyen yedi hastanın altısına mediastinoskopi bir hastaya sağ supraklavikular lenf nodu biyopsisi ile sarkoidoz tanısı kondu. EBUS-TBİA’nın sensitivitesi %92.3 spesifitesi %100 bulundu. Sonuç: Sarkoidoz şüphesi olan hastalarda granülomatöz enflamasyonu göstermede EBUS-TBİA yüksek sensitivite ve spesifiteye sahip olup, yüksek tanı oranı ile ileri invaziv işlemleri gereksiz kıldığı sonucuna varılmıştır.

Kaynakça

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

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