Sarcoidosis other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnosis of [[sarcoidosis]] requires a tissue biopsy, with the exception of rare circumstances which the clinical findings are highly specific [[sarcoidosis]]. | |||
==[[Tissue biopsy]]== | |||
The diagnosis of [[sarcoidosis]] requires a tissue [[biopsy]], with the exception of rare circumstances which the clinical findings are highly specific for [[sarcoidosis]]. It is ideal for [[biopsy]] to be minimally invasive and associated with the least [[morbidity]]. Thus, peripheral [[biopsy]] sites are preferred compared to [[visceral]] organs<ref>Teirstein AS, Judson MA, Baughman RP, et al: The spectrum of biopsy sites for the diagnosis of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 22(2):139 146, 2005.</ref>.When there is no evidence that a superficial peripheral site is involved by sarcoidosis, a [[biopsy]] is usually performed in organs which is very often the lung, because the lungs are involved in 90% of [[sarcoidosis]] patients<ref>Baughman RP, Teirstein AS, Judson MA, et al: Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 164:1885–1889, 2001.</ref>. | |||
*[[Bronchoscopy]]: different samples can be taken with a bronchoscope: | |||
#. [[Transbronchial biopsy]]: 60-97% diagnostic for sarcoidosis<ref>Poe RH, Israel RH, Utell MJ, Hall WJ: Probability of a positive transbronchial | |||
lung biopsy result in sarcoidosis. Arch Intern Med 139(Jul):761–763, 1979.</ref><ref>Koerner SK, Sakowitz AJ, Appelman RI, et al: Transbronchinal lung | |||
biopsy for the diagnosis of sarcoidosis. N Engl J Med 293(6):268–270, 1975.</ref><ref>Gilman MJ, Wang KP: Transbronchial lung biopsy in sarcoidosis. An | |||
approach to determine the optimal number of biopsies. Am Rev Respir Dis 122(5):721–724, 1980.</ref>. | |||
#. [[Endobronchial biopsy]]: positive in 60% of patients with [[pulmonary sarcoidosis]]<ref>Shorr AF, Torrington KG, Hnatiuk OW: Endobronchial biopsy for | |||
sarcoidosis: a prospective study. Chest 120(1):109–114, 2001.</ref></ref>Kieszko R, Krawczyk P, Michnar M, et al: The yield of endobronchial | |||
biopsy in pulmonary sarcoidosis: connection between spirometric impairment and lymphocyte subpopulations in bronchoalveolar lavage luid. Respiration 71(1):72–76, 2004.</ref>. | |||
#.[[Transbronchial needle aspiration(TBNA)]]: positive in 80% of patients with [[pulmonary sarcoidosis]]<ref>Agarwal R, Srinivasan A, Aggarwal AN, Gupta D: Eficacy and safety of convex probe EBUS-TBNA in sarcoidosis: a systematic review and meta-analysis. Respir Med 106(6):883–892, 2012.</ref> | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roshan Dinparasti Saleh M.D.
Overview
The diagnosis of sarcoidosis requires a tissue biopsy, with the exception of rare circumstances which the clinical findings are highly specific sarcoidosis.
Tissue biopsy
The diagnosis of sarcoidosis requires a tissue biopsy, with the exception of rare circumstances which the clinical findings are highly specific for sarcoidosis. It is ideal for biopsy to be minimally invasive and associated with the least morbidity. Thus, peripheral biopsy sites are preferred compared to visceral organs[1].When there is no evidence that a superficial peripheral site is involved by sarcoidosis, a biopsy is usually performed in organs which is very often the lung, because the lungs are involved in 90% of sarcoidosis patients[2].
- Bronchoscopy: different samples can be taken with a bronchoscope:
#. Transbronchial biopsy: 60-97% diagnostic for sarcoidosis[3][4][5]. #. Endobronchial biopsy: positive in 60% of patients with pulmonary sarcoidosis[6]</ref>Kieszko R, Krawczyk P, Michnar M, et al: The yield of endobronchial
biopsy in pulmonary sarcoidosis: connection between spirometric impairment and lymphocyte subpopulations in bronchoalveolar lavage luid. Respiration 71(1):72–76, 2004.</ref>.
#.Transbronchial needle aspiration(TBNA): positive in 80% of patients with pulmonary sarcoidosis[7]
References
- ↑ Teirstein AS, Judson MA, Baughman RP, et al: The spectrum of biopsy sites for the diagnosis of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 22(2):139 146, 2005.
- ↑ Baughman RP, Teirstein AS, Judson MA, et al: Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med 164:1885–1889, 2001.
- ↑ Poe RH, Israel RH, Utell MJ, Hall WJ: Probability of a positive transbronchial lung biopsy result in sarcoidosis. Arch Intern Med 139(Jul):761–763, 1979.
- ↑ Koerner SK, Sakowitz AJ, Appelman RI, et al: Transbronchinal lung biopsy for the diagnosis of sarcoidosis. N Engl J Med 293(6):268–270, 1975.
- ↑ Gilman MJ, Wang KP: Transbronchial lung biopsy in sarcoidosis. An approach to determine the optimal number of biopsies. Am Rev Respir Dis 122(5):721–724, 1980.
- ↑ Shorr AF, Torrington KG, Hnatiuk OW: Endobronchial biopsy for sarcoidosis: a prospective study. Chest 120(1):109–114, 2001.
- ↑ Agarwal R, Srinivasan A, Aggarwal AN, Gupta D: Eficacy and safety of convex probe EBUS-TBNA in sarcoidosis: a systematic review and meta-analysis. Respir Med 106(6):883–892, 2012.