Sarkoidozda fiberoptik bronkoskopinin tanisal verimliliğini etkileyen faktörler

Flexible bronchoscopy is a well-tolerated, less invasive procedure in diagnosisof sarcoidosis and it allows tissue sampling from several different anatomic sources.This study aimed to evaluate the clinical presentations of our sarcoidosis cohort, tofindout the diagnostic yield of FOB and its diagnostic modalities, and to evaluate thenumber of factors that might influence on the diagnostic yields of the procedures. As asecondary outcome the relation of high resolution computed tomography (HRCT)findings and the bronchoscopic diagnostic procedures were also evaluated.Patients with diagnosis of sarcoidosis were retrospectively recruited from thearchives of Gazi University School Of Medicine, Department Of Pulmonary Medicinefor a time period of Feb 2000 to Jan 2010. Demographic data, pulmonary functionresults and the site and results of FOB modalities were recorded from patient files.HRCT scans were retrospectively assessed in random order by an experienced observerwithout knowledge of the bronchoscopy result or lung function tests. 64 cases hadcomplete data and the others with incomplete data were excluded from study.Twenty nine point seven % of cases (n=19) were male while 70.3 % (n=45)were female. The mean age value was 43.4 ± 11.5 (min-max: 21-67). In 60.3% thedefinitive diagnosis was established by bronchoscopy. The diagnostic yield of TBBwas % 43.6. Although it did not reach statistical significance, the lobar HRCT score inthe sampled lobe was associated with a positive TBB. Bronchial mucosa appearancewas significantly related with positive PB. The diagnostic yield of PB was % 24.5 ingeneral patient population however in patients with abnormal mucosa this rate wasincreased up to % 84.6 (p=0.000). 89 % of patients (n=57) had enlarged mediastinallymph nodes. The most frequent location was right hilar lymph node (87.7 % n=50).The diagnostic yield of transbronchial needle aspiration (TBNA) was 25.7 %. Righthilar and subcarinal lymph nodes were the most diagnostic sites. The diagnostic yieldwas significantly higher in patients who had larger size of lymph nodes (p=0.007).The diagnostic yield was significantly higher when all the diagnostic proceduresincluding TBB, PB and TBNA performed together. Hence, HRCT may be useful to leadclinician to increase diagnostic yield of bronchoscopic procedures.