Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 6)

Тhe value of transbronchial needle aspiration cytology in the diagnosis of stage I and II sarcoidosis

Authors:
Željka Tatomirović, Vesna Škuletić, Dragana Peković, Vukoica Karličić, Branka Djurović, Saša Ristić, Ljiljana Tomić, Jelena Džambas, Snežana Cerović

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Background/Aim. Sarcoidosis is a multisystem infmamma-tory disease of unknown etiology, with the lungs and intratho-racic lymph nodes the most commonly involved. The aim of this study was to assess the contribution of conventional trans-bronchial needle aspiration (TBNA) cytology in the diagnosis of sarcoidosis presenting as mediastinal/hilar lymphadenopa-thy. Methods. In this retrospective study, 58 patients with sus-picion of stage I and II sarcoidosis underwent first flexibile, and then, a rigid bronhoscopy, during which TBNA of medi-astinal or hilar lumph node with a 19 gauge (G) needle was done. Material from the needle was put on glass slide and pre-pared for the cytological and histopathological examination. Results. Out of 58 patients submitted to TBNA of mediastinal or hilar lymph nodes, adequate material for cytological diagnos-tics was obtained in 53 (91.37%). Out of 53 adequate cytologi-cal samples, in 38 (71.69%) noncaseous granulomatous in-flammation (NGI) was found, while in corresponding histopa-thological samples, NGI was found in 48 (90.56%), which was significantly higher (p < 0.05). Of cytological smears, out of the cell types typical for granulomatous inflammation, in 26 (63.15%) patients the clusters of the epitheloid cells were found, in 8 (21.05%) there were both, clusters of epitheloid cells and giant multinuclear hystiocytes, and in 6 (15.76%) only single scattered epitheloid cells or small clusters of several epi-theloid cells were found. The sensitivity of TBNA cytology in our group of patients with sarcoidosis was 76%, specificity 100% and accuracy 77.34%. Conclusion. TBNA is an efficient and safe procedure in the diagnosis of sarcoidosis, minimally invasive and with a little risk of complications. Using 19 G needle enables obtaining material for histological and cytologi-cal analyses, as well which contribute to the sensitivity of diag-nosting sarcoidosis. The value of this type of diagnostics de-pends on qualification and experience both of bronchoscopist and cytologist/pathologist, as well, of the interpreter of such a material.