Diagnosis of intra-abdominal and mediastinal sarcoidosis with EUS-guided FNA - 23/08/11
Reprints requests: Hazar Michael, MD, Department of Medicine, Division of Gastroenterology, UMDNJ-Robert Wood Johnson Medical School, One Robert Wood Johnson Place, 478 MEB, New Brunswick, NJ 08903.Mineola, New York, USA
Abstract |
Background |
In the presence of a compatible clinical picture, the diagnosis of sarcoidosis requires pathologic confirmation of noncaseating epithelioid granuloma in affected tissues. The standard procedure of choice for most patients is a bronchoscopy with transbronchial biopsy (TBB), which has a diagnostic yield of 40% to 90%. The lowest yield with TBB is in cases that present with predominant mediastinal or intra-abdominal lymphadenopathy (LN) and minimal parenchymal lung involvement.
Objective |
To study the diagnostic yield of EUS-guided FNA in diagnosing sarcoidosis with predominant LN or masses.
Design |
Retrospective chart review.
Setting |
Teaching university hospital.
Patients |
Analysis of 21 consecutive patients with sarcoidosis and predominant mediastinal and/or intra-abdominal LN or masses who underwent EUS-guided FNA.
Results |
EUS-guided FNA diagnosed sarcoidosis in 18 of 21 patients (86%). In 3 patients, EUS-guided FNA was either not diagnostic or inconclusive, and patients underwent mediastinoscopy with lymphadenectomy, which established the diagnosis of sarcoidosis. Seven of the 21 patients (33%) had intra-abdominal LN and/or masses, and EUS-guided FNA of the intra-abdominal pathology was diagnostic of sarcoidosis in 4 of the 7 patients (57%). Four of the 21 patients (19%) had a history of malignancy, and use of EUS-guided FNA helped in ruling out the recurrence of malignancy in 3 of the 4 patients (75%).
Limitations |
Mycobacterial and fungal culture was not obtained in all patients.
Conclusions |
EUS-guided FNA offers a practical, minimally invasive technique for the diagnosis of sarcoidosis in patients who present with predominant mediastinal and/or intra-abdominal LN or masses.
Le texte complet de cet article est disponible en PDF.Abbreviations : ACE, LN, TBB, TBNA, VATS
Plan
Vol 67 - N° 1
P. 28-34 - janvier 2008 Retour au numéro
Article précédent
- Removable endoprosthetics in the management of esophageal pathology: all strictures and fistulae are not created equal…
- Michael L. Kochman
- Endoscopic hemostasis by using the TriClip for peptic ulcer hemorrhage: a pilot study
- Chun-Yiu Oliver Chan, Kwok-Kay Kevin Yau, Wing-Tai Siu, Kin-Hung Simon Wong, Yiu-Wing Luk, Tai Yuk-Ping Tai, Ka-Wah Michael Li
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?