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Bronchial and Transbronchial Lung Biopsy without Fluoroscopy in Sarcoidosis*
Section snippets
MATERIALS AND METHODS
Sixty-eight patients seen at Howard University Hospital between 1979 and 1981 who met the clinical and radiographic diagnostic criteria of pulmonary sarcoidosis were studied. There were 20 men and 48 women, all black, with ages ranging from 18 to 67 years. After a complete physical examination, each patient had the following tests: complete blood cell count; electrolyte levels; blood urea nitrogen level; chest roentgenograms; electrocardiogram; pulmonary function tests; serum angiotensin
RESULTS
Sixty-eight patients underwent transbronchial lung biopsy by this technique. One patient was found to have metastatic breast carcinoma. Of the remaining 67 patients, 51 (76 percent) had noncaseating granulomata on bronchial or transbronchial lung biopsies (or both). Of the 16 patients with a nondiagnostic biopsy specimen, histologic confirmation of sarcoidosis was obtained by other procedures (six by skin biopsy, three by scalene node biopsy, three by mediastinoscopy, and one each by
DISCUSSION
Fiberoptic bronchial and transbronchial lung biopsy for histologic confirmation of pulmonary sarcoidosis has evolved into a definitive initial procedure because of its high yield and low morbidity. In the early 1960s, prior to the development of fiberoptic bronchoscopy, techniques of open lung biopsy demonstrated diffuse involvement of the lung with microscopic granulomata in nearly all patients with sarcoidosis. This occurred even in patients without radiographic evidence of parenchymal
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