The Value of Flexible Transbronchial Needle Aspiration in the Diagnosis of Stage I Sarcoidosis

Trisolini, Rocco; Agli, Luigi Lazzari; Cancellieri, Alessandra; Poletti, Venerino; Tinelli, Carmine; Baruzzi, G; Patelli, Marco

doi:10.1378/chest.124.6.2126

Cited by 114 publications

(114 citation statements)

References 17 publications

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“…Fine-needle cytology is still underutilised in the diagnosis of sarcoidosis [25]. TRISOLINI et al [26] showed that fine-needle cytology often yields more material than that of histological samples in both patient-based (79% versus 30%) and procedure-based (70% versus 22.5%) analyses. EBUS-TBNA utilising 21-or 22-gauge needles does not usually provide ''core'' samples.…”

Section: Discussionmentioning

confidence: 99%

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

et al. 2012

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Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspirates (EBUS-TBNA) has not been compared to final detailed cytological analysis in patients with suspected sarcoidosis.To assess the diagnostic accuracy of EBUS-TBNA with ROSE in patients with suspected sarcoidosis, a prospective two-centre study performed EBUS-TBNA with ROSE of cellular material followed by transbronchial lung biopsy (TBLB) and endobronchial biopsy (EBB). The diagnostic accuracy of EBUS-TBNA with ROSE was compared to the final cytological assessment and to TBLB and EBB.Analysis confirmed 49 out of 60 cases of sarcoidosis. ROSE sensitivity was 87.8% (specificity 91%, positive predictive value 97.7%). ROSE slide interpretation in combination with the final fixed slide and cell block preparations had a sensitivity of 91.8% (specificity 100%, positive predictive value 100%). 67% of patients were confirmed as having sarcoidosis on TBLB and 29% on EBB. Interobserver agreement between cytotechnologists and pathologists was very good (k50.91, 95% CI 0.80-1.0 and k50.91, 95% CI 0.79-1.0, respectively).EBUS-TBNA with ROSE has high diagnostic accuracy and interobserver agreement and informs the bronchoscopist in theatre whether additional diagnostic procedures need to be undertaken. EBUS-TBNA with ROSE should therefore be considered as the first-line investigation of sarcoidosis. @ERSpublications Rapid on-site evaluation of EBUS-TBNA should be first-line investigation in sarcoidosis

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Section: Discussionmentioning

confidence: 99%

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

et al. 2012

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“…Some workers have reported presence of non-caseating granuloma on transbronchial biopsy of lung even in stage I sarcoidosis [9]. According to Trisolini et al [10], TBNA was diagnostic in 72% patients. The association of TBNA and TBLB increased the diagnostic yield to 87% in these patients.…”

Section: Discussionmentioning

confidence: 97%

Flexible Bronchoscopy in the Evaluation of Mediastinal and Hilar Lymphadenopathy

Rai

Bhattacharyya

Choudhary³

2007

Medical Journal Armed Forces India

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“…ACCP 2013 guideline for lung cancer found a mean pooled sensitivity of C-TBNA as 78%, ranging from 14 to 100% in terms of lung cancer (3). Studies including patients with suspicion of sarcoidosis have diagnostic sensitivities ranging from 72 to 90% (10)(11)(12). In a study including 34 patients, C-TBNA revealed a definite diagnosis in 14 patients (41.1%) and C-TBNA had a higher DY for malignancy (64.7%) compared to non-malignant diseases (17.6%) (13).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

Öztürk¹,

Sandal

Karahan³

et al. 2016

Tuberk Toraks

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SUMMARY Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients Introduction: Conventional transbronchial needle aspiration biopsy (C-TBNA) is a technique in evaluating mediastinal/hilar lymph nodes (LN). We aimed to investigate diagnostic yield (DY) and safety of C-TBNAs performed in a single university clinic. Patients and Methods: We retrospectively reviewed 363 consecutive C-TBNA procedures in 219 patients. The DY and its relationship with location, shortest diameter, SUVmax of LN, and number of sampled stations were evaluated.Results: Procedures were diagnostic in 257 (71%) LNs. The most common diagnoses were malignancy (n= 109.30%) and granulomatous inflammation (n= 68, 18.7%) biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients INTRODUCTIONTransbronchial needle aspiration (TBNA) is a minimally invasive technique for lymph node (LN) sampling to investigate etiologies of mediastinal and hilar LNs. Although TBNA was firstly described in 1949, fiberoptic bronchoscopic application was defined in 1981 (1,2). Besides conventional usage with white light bronchoscopy (C-TBNA), its bronchoscopic appliance can also be guided by newer imaging methods like endobronchial ultrasound (EBUS-TBNA).Conventional TBNA is a minimally invasive, safe, and cost-effective technique in evaluating mediastinal and enlarged LNs. Emergence and increasing use of EBUS-TBNA provided more information about this newer technique's diagnostic success and gave the opportunity to compare it with that of C-TBNA. The meta-analyses performed for the 3 rd edition of American College of Chest Physicians (ACCP) Diagnosis and Management of Lung Cancer Guideline yielded mean pooled sensitivities of 78% and 89% for C-TBNA and EBUS-TBNA, respectively (3). There are randomized trials with results suggesting better diagnostic results with EBUS-TBNA in both lung cancer and sarcoidosis patients (4-6). Despite better diagnostic results of TBNA with additional imaging, requirement for advanced devices, special equipment and experienced staff for the specific procedure makes wide range application of those techniques uneasy (7). Thus, C-TBNA may still be important for LN sampling in terms of feasibility and practicality. Herein we report the diagnostic yield (DY) and safety of C-TBNA performed in a single center at a university clinic. PATIENTS and METHODS PatientsThe study included 363 consecutively performed C-TBNA procedures in 219 patients who underwent fiberoptic bronchoscopy and C-TBNA in the Bronchoscopy Unit of Hacettepe University Adult Hospital between October 1 st , 2012 and December 31 st , 2014. With the retrospective design, the study was approved by Hacettepe University Non-interventional Clinical Researches Ethical Committee. The files of the patients were reviewed retrospectively and available study forms were duly filled in. The age, gender, radiological findings, bronchoscopic findings, sampled...

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The Value of Flexible Transbronchial Needle Aspiration in the Diagnosis of Stage I Sarcoidosis

Cited by 114 publications

References 17 publications

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis

Flexible Bronchoscopy in the Evaluation of Mediastinal and Hilar Lymphadenopathy

Diagnostic yield of conventional transbronchial needle aspiration biopsy (C-TBNA) without an on-site cytopathologist: Experience of 363 procedures in 219 patients

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