Transbronchial Lung Biopsy Via the Fiberoptic Bronchoscope in Sarcoidosis

Abstract

In a prospective study at 2 medical centers, 42 consecutive patients with suspected sarcoidosis underwent transbronchial lung biopsy during fiberoptic bronchoscopy. Transbronchial biopsy revealed noncaseating granulomas in 24 of the 38 cases (63%) in which adequate tissue was obtained. Special stains and cultures for acid-fast bacilli and fungi were negative, and sarcoidosis was subsequently diagnosed in all 42 cases. Positive biopsies were obtained in 11 of 20 patients with radiographic stage I disease, in 11 of 15 with stage II disease, and in 2 of 3 with stage III disease. There was a higher probability of a positive biopsy in patients with high symptom scores for cough, wheezing and dyspnea, and in those with a vital capacity of < 80% of predicted. The only complication was 1 small pneumothorax, which spontaneously resolved. Transbronchial lung biopsy is an attractive initial procedure for obtaining histologic confirmation of sarcoidosis.