Document Detail

Endobronchial disease and racial differences in pulmonary sarcoidosis.
MedLine Citation:
PMID:  9118697     Owner:  NLM     Status:  MEDLINE    
In a retrospective review of 7 years of Walter Reed Army Medical Center fiberoptic bronchoscopy records, 154 patients with biopsy specimen proved (122) and clinically diagnosed (32) sarcoidosis were identified. Endobronchial mucosal appearance was normal in only 70 (45%). Abnormal mucosal findings included erythema (29 patients), nodules (13), plaques (13), and cobblestoning (29). Fifty-nine patients were evaluated with endobronchial biopsies (EBBX), and non-necrotizing granulomata diagnostic of sarcoidosis were found in 42 (71%). The diagnostic yield from endobronchial biopsies was similar regardless of the type of mucosal abnormality. EBBX specimens were diagnostic in 85% of black patients and 38% of white patients (p = 0.00081), but diagnostic yield did not correlate with patient's sex, symptoms, radiographic stage of disease, or extent of physiologic abnormalities. Four patients with normal-appearing bronchial mucosa underwent EBBX, and sarcoidosis was diagnosed in two. Transbronchial lung biopsy (TBBX) specimens were diagnostic of sarcoidosis in 61 of 82 (74%) black and 28 of 56 (50%) white patients (p = 0.0038). We conclude that the bronchial mucosa appears abnormal in the majority (55%) of patients with sarcoidosis. EBBX specimens will diagnose sarcoidosis in a high percentage of such patients and should be performed routinely. EBBX may be preferable to TBBX because of its greater safety profile. In our patients, the yield of both EBBX and TBBX was significantly greater in African-Americans than white Americans.
K G Torrington; A F Shorr; J W Parker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  111     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-24     Completed Date:  1997-04-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  619-22     Citation Subset:  AIM; IM    
Pulmonary and Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC, USA.
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MeSH Terms
African Continental Ancestry Group*
Biopsy / methods
Bronchi / pathology*
European Continental Ancestry Group*
Lung / pathology
Middle Aged
Retrospective Studies
Sarcoidosis, Pulmonary / ethnology*,  pathology
Comment In:
Chest. 1997 Apr;111(4):838-40   [PMID:  9106553 ]

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