Introduction. Sarcoidosis is a multisystem disease of unknown etiology
characterized by the presence of non-caseating granulomas in the affected
tissues and organs. In most cases, biopsy of available lesions and
histological verification is required, which makes bronchoscopy a method of
choice in invasive diagnostics of sarcoidosis. Due to the construction of the
bronchoscope and biopsy instruments, high quality tissue samples can be
obtained from different anatomic locations. Transbronchial lung biopsy.
Transbronchial lung biopsy with forceps represents a standard in diagnostics
of sarcoidosis and it is always performed during bronchoscopy. Sensitivity
and specificity of this method are rising with the stage of disease and it is
performed even if chest radiography shows no changes in lung parenchyma.
Endoscopic finding in sarcoidosis and endobronchial biopsy (biopsy of
bronchial mucosa). Endobronchial biopsy results in diagnosis in 70% of
patients with sarcoidosis and positivity is even higher when combined with
transbronchial lung biopsy (76-86%). Transbronchial needle aspiration biopsy.
Transbronchial needle aspiration biopsy is a safe and widely used routine
method, especially if sarcoidosis is in stages I and II. Higher positivity
and better quality of biopsy samples can be achieved when transbronchial
needle aspiration biopsy is guided by the endobronchial ultrasound.
Bronchoalveolar lavage. The significance of bronchoalveolar lavage remains
controversial and subjected to further clinical investigations. Conclusion.
All presented data point out that all biopsy techniques available should be
used during fiberoptic bronchoscopy under suspicion of sarcoidosis,
regardless of radiographic and endoscopic appearances.
Diagnostic yield of additional conventional transbronchial lung biopsy following radial endobronchial ultrasound lung biopsy for peripheral pulmonary lesions
