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Endobronchial Biopsy as Diagnostic Tool for Sarcoidosis
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A1743 - Endobronchial Biopsy as Diagnostic Tool for Sarcoidosis
Author Block: W. U. Shah1, E. Glanville2, R. Maeve3, R. Morgan4, L. Seamus4; 1Respiratory, Connolly Hospital Dublin, Dublin, Ireland, 2Respiratory, waterford regional hospitals, waterford, Ireland, 3Pathology, Beaumont Hospital, dublin 11, Ireland, 4Respiratory, Beaumont Hospital, dublin 11, Ireland.
Sarcoidosis is a multisystem disorder of unknown aetiology. Ireland has a very high incidence of sarcoidosis and a low prevalence of other granulomatous diseases which can confuse the diagnosis. Diagnosis is often confirmed by the identification of non-caseating granulomas. Pulmonary involvement is seen in the majority of patients. Bronchoscopy has become a pivotal test for confirming the diagnosis. Endobronchial biopsy has a reported yield of 50% and is well tolerated with a low risk profile. Trans bronchial biopsy has higher complication rate. EBUS requires more special expertise and is not widely available.
Methods; we performed a retrospective analysis of biopsy proven 98 consecutive patients with sarcoidosis between January of 2013 to December of 2016. (Mean age 48 +_ 15 men).the bronchoscopies and pathologies reports were reviewed. The indications for the procedure, use of sedation and the sites sampled were recorded.
Results; only 12 patients had regular bronchoscopy before EBUS, and only 5 had endobronchial biopsies done among these 5, 3 were diagnostic (60%). Single station FNA was performed in 80 patients with station 7 being the most frequent site for FNA. Mediastinal Adenopathy was the most common indication in 44% of patients followed by abnormal CXR in 25% of patients. EBUS yielded diagnosis in 90% of the patients.
Conclusion; endobronchial biopsy remains a useful relatively safe test in the diagnosis of sarcoidosis particularly if access to endobronchial ultrasound is limited. However where readily available we would advocate EBUS as the initial and diagnostic modality of choice with a high diagnostic rate and low complication rate in appropriately selected cases. Further studies may allow accurate identification of patients where endobronchial biopsy alone may suffice.
Author Block: W. U. Shah1, E. Glanville2, R. Maeve3, R. Morgan4, L. Seamus4; 1Respiratory, Connolly Hospital Dublin, Dublin, Ireland, 2Respiratory, waterford regional hospitals, waterford, Ireland, 3Pathology, Beaumont Hospital, dublin 11, Ireland, 4Respiratory, Beaumont Hospital, dublin 11, Ireland.
Sarcoidosis is a multisystem disorder of unknown aetiology. Ireland has a very high incidence of sarcoidosis and a low prevalence of other granulomatous diseases which can confuse the diagnosis. Diagnosis is often confirmed by the identification of non-caseating granulomas. Pulmonary involvement is seen in the majority of patients. Bronchoscopy has become a pivotal test for confirming the diagnosis. Endobronchial biopsy has a reported yield of 50% and is well tolerated with a low risk profile. Trans bronchial biopsy has higher complication rate. EBUS requires more special expertise and is not widely available.
Methods; we performed a retrospective analysis of biopsy proven 98 consecutive patients with sarcoidosis between January of 2013 to December of 2016. (Mean age 48 +_ 15 men).the bronchoscopies and pathologies reports were reviewed. The indications for the procedure, use of sedation and the sites sampled were recorded.
Results; only 12 patients had regular bronchoscopy before EBUS, and only 5 had endobronchial biopsies done among these 5, 3 were diagnostic (60%). Single station FNA was performed in 80 patients with station 7 being the most frequent site for FNA. Mediastinal Adenopathy was the most common indication in 44% of patients followed by abnormal CXR in 25% of patients. EBUS yielded diagnosis in 90% of the patients.
Conclusion; endobronchial biopsy remains a useful relatively safe test in the diagnosis of sarcoidosis particularly if access to endobronchial ultrasound is limited. However where readily available we would advocate EBUS as the initial and diagnostic modality of choice with a high diagnostic rate and low complication rate in appropriately selected cases. Further studies may allow accurate identification of patients where endobronchial biopsy alone may suffice.
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