Feasibility of cytological diagnosis of sarcoidosis with endobronchial US-guided transbronchial aspiration.
PMID 23461069 · Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2012
Authors: A Kitamura; Y Takiguchi; K Kurosu; N Takigawa; F Saegusa; K Hiroshima; T Nakajima; N Tanabe; Y Nakatani; I Yoshino; K Tatsumi
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has a high diagnostic value in sarcoidosis if the obtained histological specimen is indicative of a non-caseating epithelioid-cell granuloma. However, EBUS-TBNA in sacoidosis sometimes affords solely cytological specimens. To investigate the relevance of EBUS-TBNA cytology specimens in diagnosing sarcoidosis. The study population comprised 72 patients with sarcoidosis and 116 patients who had thoracic malignancies and intrathoracic lymphadenopathy but were eventually proven to be metastasis-free (controls). The EBUS-TBNA samples obtained for these subjects were blindly evaluated for the presence of epithelioid cell clusters by 2 independent cytoscreeners and a pathologist. Interobserver variability in the specimen grading was minimal. The sensitivity and specificity were 65.3% and 94.0%, respectively. The sensitivity was high, at 87.5%, for the combined cytological and histological examinations. Of 7 controls whose cytological specimens showed epithelioid cell clusters, 3 were also deemed positive for sarcoidosis on histological examination, which indicated that they had sarcoid reaction to cancer. Cytological evaluation of the EBUS-TBNA specimens had higher sensitivity than histological evaluation alone for intrathoracic lymphadenopathy due to sarcoidosis. It should be recognized, however, that up to 6% of patients with thoracic malignancy may have sarcoid reaction in non-metastatic lymph nodes.
Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Bronchoscopy; Diagnosis, Differential; Endosonography; Feasibility Studies; Female; Humans; Lung; Male; Middle Aged; Reproducibility of Results; Retrospective Studies; Sarcoidosis, Pulmonary; Young Adult
Cite
A Kitamura; Y Takiguchi; K Kurosu; N Takigawa; F Saegusa; K Hiroshima; T Nakajima; N Tanabe; Y Nakatani; I Yoshino; K Tatsumi. Feasibility of cytological diagnosis of sarcoidosis with endobronchial US-guided transbronchial aspiration. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG (2012). PMID 23461069.