The value of mediastinoscopy in the diagnosis of thoracic sarcoidosis

Abstract

To evaluate the role of mediastinoscopy in the diagnosis of thoracic sarcoidosis. This study was retrospective. Mediastinoscopy was performed in a total of 30 patients who had enlarged mediastinal lymph nodes on chest CT and were clinically suspected of having sarcoidosis from November 1999 to June 2004. Biopsy tissues from peritracheal, retrosternal, subcarinal, or bilateral hilar regions were obtained for pathological study. All the patients had a definitive pathologic diagnosis, consisting of 24 cases of stage I and 6 stage II thoracic sarcoidosis. The diagnostic consistency between preoperation and postoperation was 40% (12/30), and the misdiagnosis rate preoperation was 60% (18/30). In this series, the initial diagnosis had been malignancy in 17 cases (57%), of whom 3 had received chemotherapy at local hospitals. The overall incidences of postoperative complication and mortality were 0. Our experience showed that mediastinoscopy is a valuable procedure which helps confirm the diagnosis of mediastinal disease. Given its safety and efficacy, it should be considered in the diagnosis and differential diagnosis of thoracic sarcoidosis of stage I or II.