Comparison of endobronchial and endoscopic ultrasound-guided needle aspiration performed by single ultrasound bronchoscope for diagnosis of sarcoidosis – A prospective study

Abstract

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) are minimally invasive techniques for the diagnosis of pulmonary sarcoidosis. Little is known about the utility of transesophageal biopsy performed by single ultrasound bronchoscope (EUS-b-FNA) for sarcoidosis. Aims and objectives: To compare directly EBUS-TBNA vs EUS-b-FNA in stage I/II of pulmonary sarcoidosis. Methods: In patients suspected of stage I/II sarcoidosis a prospective, single-center study was performed. Patients underwent EBUS-TBNA and EUS-b-FNA with 22gauge needles in one session, under conscious sedation. If negative, patients in stage I were scheduled for mediastinoscopy and in stage II for transbronchial lung biopsy. A 6 month clinical and radiological follow up was used as the reference standard. Results: From January 2011 to July 2015, 167 patients underwent EBUS-TBNA and EUS-b-FNA consequtively. Sensitivity, accuracy and negative predictive value (NPV) of EBUS-TBNA vs EUS-b-FNA were 0.58, 0.64 and 0.29 vs 0.84, 0.87 and 0.52, respectively. Sensitivity, accuracy and NPV of EUS-b-FNA were significantly higher over EBUS-TBNA (p Conclusions: After our study EUS-b-FNA seems to be the method of choice in stage I /II of pulmonary sarcoidosis, particularly in patients with predominance of mediastinal adenopathy.