Conventional Transbronchial Needle Aspiration Versus Endobronchial Ultrasound–guided Transbronchial Needle Aspiration, With or Without Rapid On-Site Evaluation, for the Diagnosis of Sarcoidosis: A Randomized Controlled Trial

Background: Endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) as a standalone modality is superior to conventional TBNA (c-TBNA) for the diagnosis of sarcoidosis. However, the overall yield is not different if combined with endobronchial biopsy (EBB) and transbronchial lung biopsy (TBLB). The utility of rapid on-site evaluation (ROSE) in a comparative evaluation of EBUS-TBNA versus c-TBNA for the diagnosis of sarcoidosis has not been previously evaluated. Methods: Eighty patients with suspected sarcoidosis were randomized 1:1:1:1 into 4 groups: c-TBNA without ROSE (TBNA-NR), c-TBNA with ROSE (TBNA-R), EBUS-TBNA without ROSE (EBUS-NR), and EBUS-TBNA with ROSE (EBUS-R). EBB and TBLB were performed in all patients. Primary objective was detection of granulomas for combined procedure. Secondary objectives were individual procedure yields, sedation dose, and procedure duration. Patients without a diagnosis following c-TBNA subsequently underwent EBUS-TBNA. Results: A total of 74 patients were finally diagnosed with sarcoidosis. Overall, granuloma detection was not significantly different between the 4 groups (68% in TBNA-NR, 89% in TBNA-R, 84% in EBUS-NR, and 83% in EBUS-R groups, P=0.49). The yield of c-TBNA in the TBNA-NR group was lower compared with that in TBNA-R group and EBUS-TBNA in EBUS groups (32%, 72%, 68%, and 67% for TBNA-NR, TBNA-R, EBUS-NR, and EBUS-R groups, respectively, P=0.04). Additional 20% patients were diagnosed when EBUS-T...
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Original Investigations Source Type: research

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CONCLUSIONS: In GCT patients, the coexistence of noncaseating granulomatous disease is common. Minimal invasive bronchoscopic techniques can serve for the cytopathologic exclusion of malignant thoracic manifestations. In our monocenter patient group the coexistence of SLL did not have any prognostic impact on overall survival. PMID: 31053525 [PubMed - as supplied by publisher]
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
n A Abstract Sarcoidosis is a T-cell driven inflammatory disease characterized by granuloma formation. Mononuclear phagocytes (MNPs)-macrophages, monocytes, and dendritic cells (DCs)-are likely critical in sarcoidosis as they initiate and maintain T cell activation and contribute to granuloma formation by cytokine production. Granulomas manifest primarily in lungs and lung-draining lymph nodes (LLNs) but these compartments are less studied compared to blood and bronchoalveolar lavage (BAL). Sarcoidosis can present with an acute onset (usually Löfgren's syndrome (LS)) or a gradual onset (non-LS). LS patients t...
Source: Journal of Leukocyte Biology - Category: Hematology Authors: Tags: J Leukoc Biol Source Type: research
Conclusion: Awake EUS-B is a safe, well tolerated procedure that can be done without sedation in patients with high risk for sedation.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Conclusion: This series reports a higher diagnostic yield than most other published studies and opens platform for direct comparison of each available needle. It also adds to the safety data for this larger needle. In addition, it raises doubt into utility of TBLB for diagnosis of sarcoidosis, which can increase the procedural complications.
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Original Investigations Source Type: research
Conclusions: A new flexible 19-G EBUS needle was successfully and safely applied in a large patient cohort for sampling of lung and enlarged mediastinal lesions with high diagnostic rates across clinical indications.
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Original Investigations Source Type: research
Abstract Background and Objective: Endobronchial ultrasound (EBUS) is a minimally invasive endobronchial technique, which uses ultrasound along with a bronchoscope to visualize the airway wall and structures that are adjacent to it. Indications for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are samplings of mediastinal, hilar lymph nodes, and tumors adjacent to airway walls. EBUS-TBNA has been used in our clinic since 2009. The aim of the study is to evaluate the sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of cytological and histologic...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Source: Respirology - Category: Respiratory Medicine Tags: Bronchoscopy and Interventional Techniques Source Type: research
Authors: Matsuura S, Mochizuka Y, Oishi K, Miyashita K, Naoi H, Mochizuki E, Mikura S, Tsukui M, Koshimizu N, Ohata A, Suda T Abstract Sarcoidosis affects multiple organs and rarely has unusual manifestations. A 78-year-old woman was referred to our hospital for coughing symptoms. A chest computed tomography (CT) scan revealed bilateral diffuse miliary patterns and right pleural effusion. Bronchoscopy showed multiple nodules in the carina and the bronchus intermedius. A CT scan of her abdomen revealed hypovascular lesions involving the pancreatic head and body. A transbronchial lung biopsy, bronchial mucosal biopsy...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Purpose of review: Several studies have investigated different bronchoscopic techniques to obtain tissue diagnosis in patients with suspected sarcoidosis when the diagnosis cannot be based on clinicoradiographic findings alone. In this review, we will describe the most recent and relevant evidence from different bronchoscopic modalities to diagnose sarcoidosis. Recent findings: Despite multiple available bronchoscopic modalities to procure tissue samples to diagnose sarcoidosis, the vast majority of evidence favors endobronchial ultrasound transbronchial needle aspiration to diagnose Scadding stages 1 and 2 sarcoidosis. T...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Robert P. Baughman and Marcel Veltkamp Source Type: research
CONCLUSIONS: The diagnostic yield of the EBUS/TBNA performed from more than one lymph node stations was significantly higher. Addition EBB to EBUS-TBNA in sarcoidosis verification may also increase the diagnostic yield.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 1.4 Interventional Pulmonology Source Type: research
More News: Bronchoscopy | Fine Needle Aspiration | Sarcoidosis | Ultrasound