Diagnostic value of endobronchial ultrasonography in sarcoidosis and factors associated with diagnosis

Abstract

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.