Diagnostic impact of EUS(b)-FNA in diagnostics of sarcoidosis

RATIONALE. Endosonography with fine-needle aspiration (EUS-FNA) became a promising method of choice for sarcoidosis, but still data regarding the contribution of EUS-FNA on final efficacy of endoscopic diagnostics are sparse. METHODS. 45 patients with suspicion for sarcoidosis (stage II) undergone a bronchoscopy with TBLB via right middle lobe, and subsequent EUS-FNA (via esophagus) using Olympus ultrasound bronchoscope with 22G needle. All EUS-FNAs were performed for lymph nodes stations 7 or 4L (3 passes per node and procedure). Diagnostic yield by histology and cytology for FNA and TBLB specimens were analyzed. RESULTS There were no complications for all biopsies. For TBLBs both histology and cytology specimens were obtained, median number of biopsies was 3. Diagnosis was confirmed by TBLB in 31/45 (69%) pts via histology, and in 14/45 pts (31%) by cytology. Cumulative efficacy of TBLB reached 34/45 (78%) pts. EUS-FNA reached an adequate cytology specimens in all cases, histology specimens were obtained only in 2/45 (4%) pts, informative material was received in 38/45 (84%) pts. Two histology specimens also were informative. The whole efficacy of EUS-FNA reached 38/45 (84%) pts. Totally, TBLB and EUS-FNA gave confirmation of disease in 41/45 (91%) pts. Difference between TBLB and EUS-FNA groups for total diagnostic yield (78% and 84% for TBLB and EUS-FNA, respectively; p>0.05) was non-significant, but cytological yield favored EUS-FNA (31% and 84% for TBLB and EUS-FNA, respectively; p<0.05). Endosonography improved diagnostic yield for sarcoidosis on 13%. CONCLUSION. According to our data, endoscopic ultrasound-guided FNA makes substantial contribution in confirmation of disease in sarcoidosis patients.