Invasive diagnosis of pulmonary sarcoidosis

Abstract

Objective — to study the need for and present our own experience of invasive diagnosis of sarcoidosis.
 Materials and methods. Ananalysis of 210 case histories of inpatients with pulmonary dissemination syndrome who under went lung biopsy was performed. Patients were divided into 2 clinical groups depending on whether the diagnosis on admission coincided with the final diagnosis established after morphological examination of lung biopsies or not. The group I — 87 patients with the same diagnosis. The group II — 123 patients whose diagnosis did not match.
 Results and discussion. 87 (70.7 %) patients from the II clinical group of the study on admission were diagnosed with sarcoidosis of the lungs and received certa in courses of specific treatment, while this disease after lung biopsy was diagnosed in only 10 (8.1 %) people. In sufficient diagnosis of lung cancer (lung carcinoma) — 4 (3.3 %) cases on admission and 37 (30.1 %) cases after lung biopsy and interstitial, granulomatous lung lesions or pneumonitis in systemic connectivet issue pathology — 4,3 %) cases before lung biopsy and 23 (18.7 %) after.The informativeness of the fibrobronchos copy was 87.5 %. In video-assisted thoracoscopic surgery, intraoperative complications were recorded in 2 (1.4 %) and post operative complications in 5 (3.4 %) cases. The informativeness of the method was 94.7 %.
 Conclusions. Invasive diagnosis of sarcoidosis is an effective safe way to diagnose, especially in complex cases and atypical clinical and radiological picture. Among invasive methods, preference should begiven to the least invasive, in stage I sarcoidosis — fibrobronchos copy, EBUS-TBNA, in stage II—III, VATS is optimal.