Role of Bronchoscopic Techniques in the Diagnosis of Thoracic Sarcoidosis

• Published in: Journal of clinical medicine Vol. 8; no. 9; p. 1327
• Main Authors: Pedro, Cecília, Melo, Natália, Novais E Bastos, Hélder, Magalhães, Adriana, Fernandes, Gabriela, Martins, Natália, Morais, António, Caetano Mota, Patrícia
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 28-08-2019
• Subjects: Review; diagnosis; recent bronchoscopic techniques; sarcoidosis; standard bronchoscopic techniques
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm8091327

The diagnosis of sarcoidosis relies on clinical and radiological presentation, evidence of non-caseating granulomas in histopathology and exclusion of alternative causes of granulomatous inflammation. Currently, a proper diagnosis, with a high level of confidence, is considered as key to the appropriate diagnosis and management of the disease. In this sense, this review aims to provide a brief overview on the role of bronchoscopy in the diagnosis of thoracic sarcoidosis, incorporating newer techniques to establish, including endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), transesophageal ultrasound-guided needle aspiration with the use of an echo bronchoscope (EUS-B-FNA) and transbronchial lung cryobiopsy (TBLC). Most of the literature reports the diagnostic superiority of endosonographic techniques, such as EBUS-TBNA alone or in combination with EUS-FNA, over conventional bronchoscopic modalities in diagnosing Scadding stages I and II of the disease. Moreover, TBLC may be considered a useful and safe diagnostic tool for thoracic sarcoidosis, overcoming some limitations of transbronchial lung biopsy (TBLB), avoiding more invasive modalities and being complementary to endosonographic procedures such as EBUS-TBNA.