scholarly journals Diagnostic yield of transbronchial needle aspiration for lymphoma

2016 ◽  
Vol 22 (3) ◽  
pp. 67
Author(s):  
B Sonnekus ◽  
J Steenkamp ◽  
M Louw ◽  
C F N Koegelenberg
Keyword(s):  
Predictive Value ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Tracheobronchial Tree ◽  
Transbronchial Needle Aspiration ◽  
Predictive Values ◽  
Hilar Adenopathy ◽  
Sensitivity Specificity

<p>Background. Transbronchial needle aspiration (TBNA) is a minimally invasive bronchoscopic technique that is cost-effective and safe for diagnosing mediastinal and hilar adenopathy in lung cancer, other malignancies, sarcoidosis and infectious processes such as tuberculosis. Few studies have analysed the sensitivity, specificity and predictive values of TBNA for diagnosing lymphoma.</p><p>Objective. To evaluate the diagnostic yield of TBNA for diagnosing mediastinal and hilar adenopathy in suspected lymphoma.</p><p>Methods. We performed a retrospective analysis of collected data of patients with mediastinal and hilar adenopathy adjacent to the tracheobronchial tree detected by thoracic computed tomography, who underwent TBNA at Tygerberg Hospital between July 2010 and June 2013. We included 25 patients with suspected or proven lymphoma. Histology was used as the gold standard.</p><p>Results. Adequate samples for cytological evaluation were obtained for 22 (88%) patients. Cytological diagnosis was possible for 8 (32%). For 17 (68%) who could not be diagnosed by TBNA alone, histology provided final diagnosis. Rapid on-site examination (ROSE) was performed in 23 (92%). In 17/23 (74%) cases, these had similar results to formal cytology. Only 4 (16%) had flow cytometry requested. Twelve (48%) had lymphoma confirmed on histology. TBNA cytology had 100% specificity and positive predictive value for suspicion of lymphoma. Sensitivity was 33% and negative predictive value 62%.</p><p>Conclusion. TBNA is an appropriate first-line diagnostic procedure in evaluating mediastinal and hilar lymphadenopathy in suspected lymphoma. Biopsy should be the immediate second-line procedure when ROSE/cytology is suspicious of lymphoma or shows atypical cells. Patients with negative TBNA cytology, but high clinical or radiological suspicion of lymphoma, should be further investigated.</p>

scholarly journals Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1110
Author(s):  
Andrea Ronchi ◽  
Marco Montella ◽  
Federica Zito Marino ◽  
Michele Caraglia ◽  
Anna Grimaldi ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Molecular Analysis ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Braf V600e ◽  
Mutational Status ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

Magnetic Resonance Imaging in the Diagnosis of Glomus Tumours of the Hand

2005 ◽  
Vol 30 (5) ◽  
pp. 535-540 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
A. AL-NAMLA ◽  
A. AL-THUNAYAN ◽  
F. AL-SUBHI ◽  
A. F. EL-SHAYEB
Keyword(s):  
Predictive Value ◽  
Final Diagnosis ◽  
Senior Author ◽  
Glomus Tumour ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Final Histological Diagnosis ◽  
Sensitivity Specificity ◽  
The Cost ◽  
Negative Imaging

This paper studies the sensitivity, specificity and predictive values of MRI in the diagnosis of glomus tumours of the hand and investigates the final diagnosis and outcome in cases with false positive or negative imaging tests. A total of 42 cases with the clinical diagnosis of a glomus tumour were included in the study. All patients underwent MRI and the results of MRI were correlated with the final histological diagnosis of the excised lesion. MRI had a sensitivity of 90%, a specificity of 50%, a positive predictive value of 97% and a negative predictive value of 20%. The four cases in which the MRI was negative all proved histologically to be glomus tumours. All four tumours were small (2–3 mm in diameter) and the lack of delineation of the lesions by MRI was attributed to their small size. Despite negative MRIs, surgical exploration identified the glomus tumours. Based on the results of the current study and the cost of MRI, the senior author has stopped ordering pre-operative MRIs in patients clinically diagnosed with a glomus tumour.

scholarly journals Correlation of fine needle aspiration cytology and histopathology of neck swellings

2018 ◽  
Vol 4 (3) ◽  
pp. 648
Author(s):  
C. S. Asha ◽  
B. R. Suchit Roy
Keyword(s):  
Salivary Gland ◽  
Lymph Node ◽  
Predictive Value ◽  
Age Groups ◽  
Invasive Procedure ◽  
High Specificity ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Predictive Values ◽  
Specificity And Sensitivity

<p class="abstract"><strong>Background:</strong> Neck swellings are a common clinical finding affecting all age groups. FNAC is a minimally invasive procedure helpful in the diagnosis of various neck swellings. The purpose of this study is to determine the accuracy of FNAC in the diagnosis of neck swellings by comparing it with the histopathology which is taken as the gold standard.</p><p class="abstract"><strong>Methods:</strong> A prospective study which included 90 patients who attended ENT and surgery departments of Government Medical College, Trivandrum with neck swellings from July 2006-2007. FNAC of the swelling was done and the FNAC results were compared with the histopathology results. The specificity, sensitivity, positive and negative predictive values and accuracy of FNAC were calculated.  </p><p class="abstract"><strong>Results:</strong> Of the 90 patients, thyroid swelling formed the major group followed by lymph node, salivary gland and miscellaneous swellings. Thyroid swellings had a female predominance while the other three groups namely lymph node, salivary gland and miscellaneous groups showed a male preponderance. When the neck swellings namely thyroid, salivary gland, lymph node and miscellaneous group were taken into consideration as a whole, the sensitivity of FNAC for detecting malignancy was 64.3%. The specificity, positive predictive value, negative predictive value and accuracy were 97.4%, 81.8%, 93.7% and 92% respectively.</p><p class="abstract"><strong>Conclusions:</strong> FNAC can be rated as a safe, simple, reliable, cost effective and rapid diagnostic tool with high specificity and sensitivity for the initial evaluation of neck swellings.</p>

scholarly journals Utility of on-site evaluation of endobronchial ultrasound-guided transbronchial needle aspiration specimens

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 20 ◽  
Author(s):  
Adrienne Carruth Griffin ◽  
Lauren Ende Schwartz ◽  
Zubair W. Baloch
Keyword(s):  
Clinical Decision Making ◽  
Malignant Tumors ◽  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Ultrasound Guided ◽  
Cytologic Diagnosis ◽  
Transbronchial Needle Aspiration ◽  
Site Evaluation

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an integral tool in the diagnosis and staging of malignant tumors of the lung. Rapid on-site evaluation (ROSE) of fine needle aspiration (FNA) samples has been advocated for as a guide for assessing the accuracy and adequacy of biopsy samples. Although ROSE has proven useful for numerous sites and procedures, few studies have specifically investigated its utility in the assessment of EBUS-TBNA specimens. The intention of this study was to explore the utility of ROSE for EBUS-TBNA specimens. Materials and Methods: The pathology files at our institution were searched for all EBUS-TBNA cases performed between January 2010 and June 2010. The data points included number of sites sampled per patient, location of site(s) sampled, on-site evaluation performed, preliminary on-site diagnosis rendered, final cytologic diagnosis, surgical pathology follow-up, cell blocks, and ancillary studies performed. Results: A total of 294 EBUS-TBNA specimens were reviewed and included in the study; 264 of 294 (90%) were lymph nodes and 30 of 294 (10%) were lung mass lesions. ROSE was performed for 140 of 294 (48%) specimens. The on-site and final diagnoses were concordant in 104 (74%) and discordant in 36 (26%) cases. Diagnostic specimens were obtained in 132 of 140 (94%) cases with on-site evaluation and 138 of 154 (90%) without on-site evaluation. The final cytologic diagnosis was malignant in 60 of 132 (45%) cases with ROSE and 46 of 138 (33%) cases without ROSE, and the final diagnosis was benign in 57 of 132 (47%) with ROSE and 82 of 138 (59%) without ROSE. A cell block was obtained in 129 of 140 (92%) cases with ROSE and 136 of 154 (88%) cases without ROSE. Conclusions: The data demonstrate no remarkable difference in diagnostic yield, the number of sites sampled per patient, or clinical decision making between specimens collected via EBUS-TBNA with or without ROSE. As a result, this study challenges the notion that ROSE is beneficial for the evaluation of EBUS-TBNA specimens.

scholarly journals Diagnostic yield of rapid on-site evaluation transbronchial needle aspiration versus conventional transbronchial needle aspiration: a single center experience

2020 ◽  
Vol 90 (1) ◽  
Author(s):  
Carmine Guarino ◽  
Mariano Mollica ◽  
Cristiano Cesaro ◽  
Adriano Costigliola ◽  
Maria Carolina Micheli ◽  
...  
Keyword(s):  
Lymph Node ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Diagnostic Testing ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Lymph Node Involvement ◽  
Transbronchial Needle Aspiration ◽  
Single Center Experience ◽  
Site Evaluation

Trans-bronchial needle aspiration allows lymph node sampling in several thoracic conditions; the ability of Rapid On-Site Evaluation (ROSE) to predict the final diagnosis in this setting has not been well characterized. We performed a retrospective study to establish the utility of ROSE in the diagnosis of thoracic diseases with mediastinal lymph node involvement. We retrospectively reviewed 297 patients with hilar-mediastinal lymph node enlargement detected at CT scan from January 2013 to April 2016. 201 patients underwent conventional TBNA; in 96 patients, TBNA procedure was performed by on-site presence of a team of pathologists and research morphologists. Lung neoplasms, sarcoidosis, infections and lymphoma were the most common diseases diagnosed with TBNA samples. TBNA simultaneously performed in combination with ROSE produced an increase in percentage of appropriate samples compared to single cTBNA (adequate samples cTBNA vs ROSE-TBNA: 73% vs 81%; p<0.05). Our observations indicate an increase in adequacy of fine needle aspirations and increased diagnostic yield in the ROSE group. In conclusions, ROSE may serve to reduce procedure time and enhance sample triaging therefore limiting the need for further invasive diagnostic testing.

scholarly journals Diagnostic yield of endoscopic ultrasound-guided tissue acquisition for small solid pancreatic lesions

2020 ◽  
Vol 08 (10) ◽  
pp. E1359-E1364
Author(s):  
Takafumi Mie ◽  
Takashi Sasaki ◽  
Ryo Kanata ◽  
Takaaki Furukawa ◽  
Tsuyoshi Takeda ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Pancreatic Abscess ◽  
Ultrasound Guided ◽  
Predictive Values ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Sensitivity Specificity

Abstract Background and study aims Endoscopic ultrasound (EUS)-guided tissue acquisition is sometimes required to diagnose small solid pancreatic lesions. The aim of this study was to evaluate the diagnostic yield of EUS-guided tissue acquisition for small solid pancreatic lesions and the differences in diagnostic yield among different needles. Patients and method We retrospectively analyzed consecutive patients who had undergone EUS-guided tissue acquisition for solid pancreatic lesions less than 2 cm between November 2012 and June 2019. Three types of needles were evaluated in this study: a 22-gauge fine-needle aspiration (FNA) Lancet needle, a 20-gauge fine-needle biopsy (FNB) Menghini needle with a lateral forward bevel, and a 22-gauge FNB Franseen needle. We evaluated the diagnostic yield and safety of the procedure using these needles. Results We analyzed 160 patients with 163 lesions. The overall sensitivity, specificity, and accuracy were 92.0 %, 100 %, and 92.6 %, respectively. In the histological plus cytological diagnosis, accuracies of the Lancet, Menghini, and Franseen needles were 92.7 %, 97.0 %, and 85.7 %, respectively (P = 0.10). In the histological diagnosis alone, the negative predictive values (NPVs) of the Lancet, Menghini, and Franseen needles were 13.3 %, 53.3 %, and 27.3 %, respectively (P = 0.08). Adverse events occurred in four cases (2.5 %): one postprocedural bleeding, two cases of pancreatitis, and one pancreatic abscess. Conclusions EUS-guided tissue acquisition for small solid pancreatic lesions has a high diagnostic yield and safety. This study suggested a difference in the diagnostic yield of each needle for small solid pancreatic lesions.

scholarly journals Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Cytological Smears and Cell Blocks: A Single-Institution Experience

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 19 ◽  
Author(s):  
Marius Žemaitis ◽  
Greta Musteikienė ◽  
Skaidrius Miliauskas ◽  
Darius Pranys ◽  
Raimundas Sakalauskas
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Medical Documentation ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

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 histological specimens, and the safety of EBUS-TBNA in an unselected patient population that has been referred to our hospital. Materials and Methods: We have retrospectively analyzed the medical documentation of 215 patients who had EBUS-TBNA performed in our clinic from April 2009 to February 2014. Results: There were 215 patients who underwent EBUS-TBNA. A total of 296 lymph nodes were sampled. EBUS-TBNA was diagnostic in 176 (81.9%) cases of cytological, 147 (68.4%) cases of histological, and 191 (88.9%) cases of the combined evaluation. In the lung cancer patients, EBUS-TBNA cytology had a sensitivity of 72.9% and histology of 72.9%, and in the sarcoidosis group, it had a cytology of 55.8% and histology of 64.5%. As all positive cytology and histology specimens were assumed to be true positive, specificity and positive predictive value (PPV) were 100%. The sensitivity and diagnostic accuracy was significantly higher when cytology and histology specimens were combined, compared with cytology or histology results evaluated separately (p < 0.05) (for lung cancer 84.1% and for sarcoidosis 78.8%). The sensitivity and diagnostic accuracy of EBUS-TBNA procedures increased significantly over time, with increased experience. There were no complications with EBUS-TBNA in our clinical practice. Conclusions: EBUS-TBNA had a high diagnostic yield and was safe in the diagnosis of lung cancer and sarcoidosis. It was most informative when cytology and histology were combined. The informative value of EBUS-TBNA histology increased with our experience.

Utility of High-Resolution Sonography for Evaluation of Knee Joint Pathologies as a Screening Tool

2021 ◽  
pp. 875647932110357
Author(s):  
Atul Pratap Singh ◽  
Shruti Chandak ◽  
Arjit Agarwal ◽  
Ankur Malhotra ◽  
Ashwani Jain ◽  
...  
Keyword(s):  
High Resolution ◽  
Knee Joint ◽  
Predictive Value ◽  
Screening Tool ◽  
Diagnostic Yield ◽  
Cost Effective ◽  
Joint Effusion ◽  
Symptomatic Knee ◽  
Good Diagnostic Accuracy ◽  
Sensitivity Specificity

Objective: Magnetic resonance imaging (MRI) has been established as the gold standard imaging technique for assessing knee joint pathologies. However, high-resolution sonography (HRS) is affordable, easily available, cost-effective, and can be used for knee joint assessment. This study was conducted to assess the diagnostic yield of HRS in the evaluation of knee joint pathologies compared with MRI. Materials and Methods: In the study, 103 patients, with symptomatic knee pain, were included. HRS was performed followed by MRI. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Kappa values were calculated to assess the performance of HRS compared with MRI. Results: The most frequent pathologies observed on HRS were knee joint effusion (84%) followed by medial meniscal (43%) and lateral meniscal (26%) tear. Conclusion: HRS demonstrated good diagnostic accuracy in diagnosis of knee joint pathologies as compared with MRI. Therefore, HRS could be utilized as a screening tool for detection of knee joint pathologies.

scholarly journals THU0414 ORDINARY LIGHT MICROSCOPY IS ABLE TO IDENTIFY MOST CRYSTAL-CONTAINING SYNOVIAL FLUIDS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 444.1-445
Author(s):  
J. A. Bernal ◽  
M. Andres ◽  
S. López Salguero ◽  
V. Jovani ◽  
P. Vela-Casasempere ◽  
...  
Keyword(s):  
Light Microscopy ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Polarized Light ◽  
Predictive Values ◽  
First Order ◽  
Polarized Microscopy ◽  
Ordinary Light ◽  
Sensitivity Specificity ◽  
Msu Crystals

Background:Optical microscopy remains the gold standard for the diagnosis of crystal arthropathies. The complete protocol consists of three phases. In the first stage, microscopy with simple light provides information on the morphology of the crystal. The second stage, polarized light, allows detecting the intensity of the birefringence. Finally, with the first-order red compensator, the type of elongation is detected, positive for calcium pyrophosphate (CPP) crystals and negative for monosodium urate (MSU) crystals. Finally, with the obtained data, the presence and type of crystals is concluded.Objectives:Analyze the validity and agreement of each stage of microscopy regarding the conclusion, emphasizing ordinary light microscopy.Methods:Fifty consecutive samples of synovial fluid obtained in routine clinical practice were independently analyzed under the compensated polarized microscope by 5 observers blinded to clinical data (250 observations in total). Each observer recorded the presence and type of crystals at each stage and reached a conclusion after gathering all the information. To estimate the diagnostic yield of each microscope stage, sensitivity, specificity and positive and negative predictive values, as well as the accuracy (number of correct observations/number of total observations), were calculated; also, the total weighted kappa was used to assess the degree of agreement with the complete protocol.Results:Main results of the study are shown in Table 1. Regarding diagnostic yield, ordinary light microscopy showed excellent sensitivity, specificity and predictive values, similar to the results noted with simple and compensated polarized microscopy.Table 1.In parentheses, 95% confidence intervals.AccuracySensitivitySpecificityPositive predictive valueNegative predictive valueKappaOrdinary light96.8%(93.8-98.4)97.2%(93.1-98.9)96.2%(90.7-98.5)97.2%(93.1-98.9)96.2%(90.7-98.5)0.954(0.919-0.989)Simple polarized light92.0%(88.0-94.8)84.1%(76.8-89.5)100%(97.0-100)100%(96.5-100)86.1%(79.5-90.8)0.874(0.821-0.927)Compensated polarized light97.6 %(94.9-98.9)95.5%(89.8-98.0)99.3%(96.1-99.9)99.1%(94.8-99.8)96.5%(92.1-98.5)0.962(0.933-0.992)Diagnoses established by ordinary light microscopy matched conclusions (accuracy) in 242/250 (96.8%) observations. Discrepant cases were crystals missed under ordinary light in 4 cases (3 MSU, 1 CPP), and 4 samples with CPP crystals initially seen but later concluded their absence. Interestingly, lowest accuracy was seen with simple polarization; CPP crystals were not detected in 20 out of 93 observations with CPP (21.5%). The accuracy of compensated polarized light was similar to ordinary light. On 5 occasions no crystals were seen but finally they were present (1 MSU, 4 CPP); on the contrary, CPP was registered in one observation but the conclusion indicated no crystals.Regarding agreement with the complete protocol, the kappa with simple light is 0.954, similar to compensated polarized light (0.962), while simple polarized light showed the lowest agreement (0.874).Conclusion:Ordinary light microscopy is enough to correctly reach the majority of diagnoses, with a very high degree of agreement with the complete protocol. Results were comparable to using a compensated polarized microscopy. Thus, if a microscope with polarizer and first-order compensator was not available, using ordinary light would be enough on most occasions. Polarized light microscopy better identifies MSU crystals, but over 20% of CPP crystals were missed at this stage, reinforcing the value of the ordinary light microscopy.Acknowledgments:Thanks to Loreto Carmona for the help with the statistical aspects.Disclosure of Interests: :None declared

scholarly journals Simultaneous amplification and testing method forMycobacterium tuberculosisrRNA to differentiate sputum-negative tuberculosis from sarcoidosis

2019 ◽  
Vol 316 (3) ◽  
pp. L519-L524 ◽  
Author(s):  
Qiu-Hong Li ◽  
Yuan Zhang ◽  
Meng-Meng Zhao ◽  
Ye Gu ◽  
Yang Hu ◽  
...  
Keyword(s):  
Predictive Value ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Sputum Smear ◽  
Transbronchial Needle Aspiration ◽  
Simultaneous Application ◽  
Testing Method ◽  
Biopsy Specimens ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sensitivity Specificity

We use the simultaneous application and testing method to detect Mycobacterium tuberculosis rRNA (SAT-TB) with the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy specimens to differentiate sputum-negative tuberculosis from sarcoidosis. In the first part, we validated the SAT-TB on the bronchial or EBUS-TBNA biopsy specimens from sputum smear-positive pulmonary tuberculosis. In the second part, all EBUS-TBNA specimens for sputum smear-negative intrathoracic tuberculous lymphadenopathies or sarcoidosis were tested with the SAT-TB, acid-fast bacilli smear, and culture. In the 16 sputum-positive tuberculosis cases, 5 showed negative SAT (2 nontuberculous mycobacteria and 3 had anti-tuberculosis therapies previously); the remaining 11 were positive. Of the 41 sputum-negative tuberculosis cases in the second part, five other diseases were negative. In the remaining 36 cases, 27 sarcoidosis cases were negative; 7 in 9 with sputum-negative tuberculosis were positive (77.78%). In these 36 patients, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the SAT method were 77.78, 100, 100, 93.10, and 94.44%, respectively. The SAT distinguished sputum-negative tuberculosis from sarcoidosis significantly ( P < 0.0001) and identified cases with active M. tuberculosis as accurately as the conventional methods (κ = 0.912, P < 0.0001). We conclude that the SAT-TB may be an effective method for using biopsy specimens to differentiate sputum-negative tuberculosis from sarcoidosis.

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