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. 2024 Jun 28;41(2):e2024029.
doi: 10.36141/svdld.v41i2.14192.

The role for endobronchial biopsy in the era of endobronchial ultrasound guided transbronchial needle aspiration for the diagnosis of sarcoidosis: a single center experience

Roy Cho  1 , Vidhay Pandey  1 , Jennifer Wong  1 , Joseph Keenan  1 , Erhan Dincer  1 , Emilian Racila  1 , Tadashi Allen  1 , David Perlman  1 , Maneesh Bhargava  1
Affiliations

The role for endobronchial biopsy in the era of endobronchial ultrasound guided transbronchial needle aspiration for the diagnosis of sarcoidosis: a single center experience

Roy Cho et al. Sarcoidosis Vasc Diffuse Lung Dis. .

Abstract

Background and aim: Endobronchial biopsy (EBBX) has been reported to increase diagnostic yield for pulmonary sarcoidosis. The purpose of this study is to investigate the diagnostic yield for EBBX following endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA).

Methods: We identified a cohort of patients in the University of Minnesota Sarcoidosis Registry who had EBBx and EBUS-TBNA as part of workup for abnormal chest imaging. Data regarding demographics, biopsy approach and technique were recorded.

Results: Our cohort included 37 patients (53.24±9.5, Male, 22±0.57; 3.8% were African American). In these patients who had EBBX, EBUS-TBNA was performed in 100% of patients and TBBX was performed in 2 patients (5%). EBBX was positive in 9 patients (24%) and EBUS-TBNA was positive in 34 patients (92%). TBBX was diagnostic in one of two patients. EBBX was the only diagnostic tissue in 3 of the 37 patients (8%). Conclusion: The diagnostic yield of EBBX is lower than previously reported, with only 8% of EBBXs demonstrating granulomatous inflammation. However, instrumentation used for obtaining EBBX as well as the presence of visible lesions does influence the diagnostic yield. Studies with adequate power are needed before implementing changes in clinical practice. When performed alongside EBUS-TBNA, EBBX did not significantly add to the diagnostic yield in sarcoidosis unless visible lesions were observed.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Histopathological specimens acquired from EBUS-TBNA of a mediastinal lymph node illustrating non-necrotizing granulomas in the cytology specimen. Images were from our cohort and taken at 200x (a scale bar is included in each image).
Figure 2.
Figure 2.
Classic “cobblestoning” finding demonstrated on white light bronchoscopy of the right mainstem and right upper lobe take-off in a patient diagnosed with sarcoidosis. Images were from our cohort and taken with an Olympus bronchoscope (BF-H190 model).
See this image and copyright information in PMC

References

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