Document Detail


Combination of endobronchial ultrasound-guided transbronchial needle aspiration with standard bronchoscopic techniques for the diagnosis of stage I and stage II pulmonary sarcoidosis.
MedLine Citation:
PMID:  21261784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Standard bronchoscopic techniques (transbronchial lung biopsy and endobronchial biopsy) provide a diagnosis in 70% of patients with pulmonary sarcoidosis. Previous data suggest that endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has a high sensitivity in patients with sarcoidosis. The feasibility and utility of combining EBUS-TBNA with standard bronchoscopic techniques is unknown. The aim of this study was to evaluate the feasibility, safety and efficacy of combined EBUS-TBNA and standard bronchoscopic techniques in patients with suspected sarcoidosis and enlarged mediastinal or hilar lymphadenopathy.
METHODS: Forty consecutive patients with suspected pulmonary sarcoidosis and enlarged mediastinal or hilar lymph nodes (radiographical stage I and stage II) underwent EBUS-TBNA followed by transbronchial biopsies and endobronchial biopsies under conscious sedation.
RESULTS: Thirty-nine out of 40 patients successfully underwent combined EBUS-TBNA and standard bronchoscopy. Twenty-seven patients were diagnosed with sarcoidosis, eight had tuberculosis, two had reactive lymphadenopathy, two had lymphoma and one had metastatic adenocarcinoma. In patients with sarcoidosis, the sensitivity of EBUS-TBNA for detection of non-caseating granulomas was 85%, compared with a sensitivity of 35% for standard bronchoscopic techniques (P < 0.001). The diagnostic yield of combined EBUS-TBNA and bronchoscopy was 93% (P < 0.0001).
CONCLUSIONS: Combination of EBUS-TBNA with standard bronchoscopic techniques is safe and feasible, and optimizes the diagnostic yield in patients with pulmonary sarcoidosis and enlarged intrathoracic lymphadenopathy.
Authors:
Neal Navani; Helen L Booth; Gabrijela Kocjan; Mary Falzon; Arrigo Capitanio; James M Brown; Joanna C Porter; Sam M Janes
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  16     ISSN:  1440-1843     ISO Abbreviation:  Respirology     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-30     Completed Date:  2011-07-27     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  467-72     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis,  pathology,  secondary,  ultrasonography
Adult
Aged
Biopsy, Needle / methods*
Bronchi / pathology,  ultrasonography
Bronchoscopy / methods*
Female
Humans
Lymphatic Diseases / diagnosis,  pathology,  ultrasonography
Lymphoma / diagnosis,  pathology,  ultrasonography
Male
Middle Aged
Sarcoidosis, Pulmonary / diagnosis*,  pathology,  ultrasonography
Sensitivity and Specificity
Tuberculosis, Pulmonary / diagnosis,  pathology,  ultrasonography
Young Adult
Grant Support
ID/Acronym/Agency:
091730//Wellcome Trust; G0800465//Medical Research Council; //Wellcome Trust
Comments/Corrections

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