Endobronchial Ultrasound Elastography Helps Identify Fibrotic Lymph Nodes in Sarcoidosis

Endobronchial ultrasound‐guided transbronchial needle aspiration in sarcoidosis: Beyond the diagnostic yield

“…However, one ex vivo study in abdominal lymph nodes has shown a correlation between strain elastography and the extent of fibrosis in patients with Crohn's disease . Very recently, the first report was published showing clear pathological evidence of a significant amount of fibrosis in EBUS‐TBNA specimens from a sarcoidosis patient in whom elastography suggested the presence of lymph node fibrosis . This report will likely encourage clinical research investigating the influence of lymph node fibrosis on the density of granulomas, starting with a method (i.e.…”

Role of endobronchial ultrasound strain elastography in the identification of fibrotic lymph nodes in sarcoidosis: A pilot study

“…[1][2][3][4] Clinical experience and anecdotal reports suggest that at least some of the non-diagnostic EBUS-TBNA in sarcoidosis may be caused by the presence of lymph nodes with extensive fibrosis. 2,5 We assessed the role of EBUS-strain elastography (EBUS-SE) in sarcoidosis patients enrolled in Nijmegen (The Netherlands) and Bologna (Italy) in the setting of the E-predict study. This was an international, multicentre prospective study aimed at assessing the reproducibility and the added clinical value of EBUS-SE in patients undergoing the procedure for mediastinal staging of lung cancer or suspected sarcoidosis (clinicaltrials.gov identifier: NCT02488928).…”

“…9 Third, a recently published case report has shown the association between low strain as measured by a 'blue' colorimetric elastography pattern and the presence of a large amount of fibrotic strands and very few non-necrotizing granulomas encased in fibrosis in a patient with stage II sarcoidosis. 5 Lastly, lymph nodes characterized by low strain at elastography typically offer a high level of resistance upon needle advancement during sampling, 2 which in turn is strongly suggestive of fibrotic lymph node changes (Fig. 1).…”

“…Rocco Trisolini, 1,2 * Roel L.J. Verhoeven, 3,4 * Alessandra Cancellieri, 5,6 Annalisa De Silvestri, 7 Filippo Natali 2 and Erik H.F.M. Van der Heijden 3…”

Reply to Letter to the Editor: “Influential Factors for Assessing Endobronchial Ultrasound Elastography” by Uchimura et al. Respiration. DOI: 10.1159/000510643

“…Sarcoidosis however may be of more relevance in the differential diagnosis of lung cancer in our population. The results of EBUS strain elastography in sarcoidosis are studied in more detail in collaboration with Professor Trisolini’s team and have been recently published [3, 4]. In that study, we present preliminary evidence that lymph node relative strain, as measured by EBUS strain elastography, is a likely surrogate of the extent of fibrosis and is significantly associated with increased inadequacy rate of EBUS-TBNA specimens in sarcoidosis [4].…”