Abstract
Mediastinoscopy was performed for confirmation of the diagnosis in 68 patients who
were suspected clinically and radiologically of having sarcoidosis. In 66 of 68 cases
in which mediastioscopy was performed a diagnosis was attained. In 35 cases, endobronchial
biopsy was performed by bronchoscopy. In only 5 of these (14.2 %) was the diagnosis
of sarcoidosis confirmed. The sensitivity of mediastinoscopy was remarkably superior
compared with that of endobronchial biopsy. No complication developed with either
mediastinoscopy or endobronchial biopsy. In Turkey, mediastinoscopy without any complication
costs about 650 USD while bronchoscopy and endobronchial biopsy cost about 150 USD.
In our study in which we looked for a histological confirmation - in the cases suspected
of sarcoidosis - mainly through mediastinoscopy and rarely through other methods (i.e.,
endobronchial biopsy in one case, skin biopsy in another), we did not come up with
a different diagnosis. Therefore, patients suspected of having sarcoidosis should
undergo a careful clinical, laboratory, and radiologic examination; they should be
under continuous close observation; when necessary (e.g., skin and lip biopsy), the
tissue diagnosis should be made by other methods, but if there is the possibility
of a disease such as tuberculosis and lymphoma, mediastinoscopy should be performed.
The diagnosis of stage 3 sarcoidosis is difficult. For diagnosis, sometimes videothoracoscopy
or explorative thoracotomy may be necessary. However, in all our 3 cases with stage
3, we reached the diagnosis of sarcoidosis by the less invasive and less expensive
method of mediastinoscopy. Despite our small number of cases, we believe that mediastinoscopy
is a very important instrument for diagnosis of stage 3 sarcoidosis.
Key words
Mediastinoscopy - sarcoidosis - endobronchial biopsy - bronchoscopy
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Prof. Dr. Halil Yanardağ
İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi
İç Hastalıkları Ana Bilim Dalı, Akciğer Hastalıkları Bölümü
Aksaray, İstanbul
Turkey
Telefon: + 902125879078
eMail: halilyanardag@yahoo.com