Efficacy and safety of bronchoscopic diagnostic procedures of sarcoidosis: A retrospective study

Abstract

Sarcoidosis is a chronic systemic granulomatous disorder of unknown etiology, which most commonly presents with bilateral hilar adenopathy and pulmonary infiltrates. Fiberoptic bronchoscopic procedures are the most important tools for the diagnosis sarcoidosis. PurposeA retrospective study was done to evaluate the efficacy and safety of bronchoscopic diagnostic procedures in pulmonary sarcoidosis. Patients and methodsThis retrospective study was done by reviewing the records of the bronchoscopic procedures and pathological reports performed between May 2012 and September 2015 to assess the diagnostic yield, and safety and bronchoscopic procedures (TBNA, EBB and TBLB) of cases of sarcoidosis done in the bronchoscopy unit of Chest Department, Mansoura University. We included adult patients with mediastinal lymphadenopathy with or without diffuse pulmonary infiltrate with suspected sarcoidosis with indicated fiberoptic bronchoscopy and excluded patients unfit for FOB with uncorrectable bleeding diathesis, patients with uncontrolled cardiac comorbidities and respiratory failure. The diagnostic yield and complications were the endpoints of our study. ResultsRegarding the diagnostic yield, TBNA showed the diagnosis of 4 out of 8 patients (50%) in stage I and 3 out of 5 patients (60%) in stage II. In all the studied cases, TBNA showed the diagnosis of 7 out of 13 patients (53.8%). EBB showed the diagnosis of 2 out of 2 (100%) in stage I, 1 out of 2 patients (50%) in stage II and 1 out of 2 patients (50%) in stage III. In all the studied cases, EBB showed the diagnosis of 4 out of 6 patients (66.7%). TBLB∕EBB showed the diagnosis of 6 out of 12 patients (50%) in stage II and diagnosis of 4 out of 7 patients (57%) in stage III. In all the studied cases, TBLB∕EBB showed the diagnosis of 10 out of 19 patients (52.6%). Pneumothorax developed only in 4 patients (12%), hemoptysis developed in 5 patients (16%) and no procedure related mortality. ConclusionThe bronchoscopic diagnostic procedures (TBNA, EBB and TBLB) are effective and safe in the diagnosis of pulmonary sarcoidosis.