HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (20) Citing Articles via Google Scholar Google Scholar Articles by Shorr, A. F. Articles by Hnatiuk, O. W. Search for Related Content PubMed PubMed Citation Articles by Shorr, A. F. Articles by Hnatiuk, O. W.

Endobronchial Biopsy for Sarcoidosis^*

A Prospective Study

^* From the Pulmonary and Critical Care Medicine Service, Department of Medicine, Walter Reed Army Medical Center, Washington, DC.

Correspondence to: Andrew Shorr, MD, MPH, Pulmonary and Critical Care Medicine, Walter Reed Army Medical Center, 6900 Georgia Ave, NW, Washington, DC 20307; e-mail: AFSHORR{at}DNAMAIL.COM

Study objectives: To determine the yield of endobronchial biopsy (EBB) for suspected sarcoidosis, and to evaluate if EBB increases the diagnostic value of fiberoptic bronchoscopy (FOB) when added to transbronchial biopsy (TBB).

Design: Prospective study of consecutive patients.

Setting: Pulmonary clinic of a tertiary-care, academic medical center.

Patients: Patients consecutively referred for suspected pulmonary sarcoidosis.

Interventions: All patients having FOB performed underwent an evaluation that included history, physical examination, a chest radiograph, and spirometry. During FOB, airway appearance was recorded and both TBB and EBB were performed in a standardized fashion. Six TBB specimens were obtained, as were six EBB samples. For patients with abnormal-appearing airways, four specimens were obtained from the abnormal-appearing airways and two specimens were obtained from the main carina. In patients with normal-appearing airways, four specimens were obtained from a secondary carina and two specimens were obtained from the main carina. A biopsy finding was considered positive if it demonstrated nonnecrotizing granulomas with special stains that were negative for fungal and mycobacterial organisms.

Measurements and results: The study cohort included 34 subjects (mean ± SD age, 37.9 ± 6.8 years; 58.8% were male; 64.7% were African American). EBB findings were positive in 61.8% of patients, while TBB showed nonnecrotizing granulomas in 58.8% of subjects. The addition of EBB increased the yield of FOB by 20.6%. Although EBB findings were more frequently positive in abnormal-appearing airways (p = 0.014), EBB provided diagnostic tissue in 30.0% of patients with normal-appearing endobronchial mucosa. There were no complications resulting from the addition of EBB to TBB.

Conclusions: Endobronchial involvement is common in sarcoidosis. EBB has a yield comparable to TBB and can safely increase the diagnostic value of FOB. Pulmonologists should consider routinely performing EBB in cases of suspected sarcoidosis.

Key Words: airway • biopsy • bronchoscopy • endobronchial • sarcoidosis • transbronchial

This article has been cited by other articles:

				S. Garwood, M. A. Judson, G. Silvestri, R. Hoda, M. Fraig, and P. Doelken Endobronchial Ultrasound for the Diagnosis of Pulmonary Sarcoidosis Chest, October 1, 2007; 132(4): 1298 - 1304. [Abstract] [Full Text] [PDF]

				G. R. Pesola, M. Kurdi, M. Olibrice, A. F. Shorr, K. G. Torrington, and O. W. Hnatiuk Endobronchial Sarcoidosis and Hyperreactive Airways Disease Chest, June 1, 2002; 121(6): 2081 - 2081. [Full Text] [PDF]