The diagnostic methods in pulmonary sarcoidosis

Aim: The aim of the study was to evaluate the ratio of diagnosis of sarcoidosis with invasive methods in our patients thought to have sarcoidosis clinically and radiologically. Material and methods: In this study we investigated 44 patients in our clinic (in Yedikule Chest Diseases and Thoracic Surgery Hospital) retrospectively. We evaluated the patients according to the chest x-rays. We performed PPD test, determined serum ACE level, urine calcium level as laboratory tests; TBB, CD4/CD8 ratio and cell formula in BAL, TBNA of mediastinal lymph nodes and mediastioscopy was used as diagnostic methods. Results: Thirty one of the patients were female and 13 were male. Twenty six cases (59%) were stage I, 15 (34%) stage II, 3 (6.8%) stage III. PPD was positive in 5 of 40 cases (12.5%), ACE was high in 22 of 35 cases (62.9%), urine calcium was high in 5 of 33 cases (6.8%). We observed non-necrotizing inflamation in 23 of 38 cases (60.2%) with TBB. We obtained pathological diagnosis with TBNA in 11 of 15 cases (71.3%). We observed lymphocytic alveolitis in 42 cases (81.8%), CD4/CD8 ratio >3 in 29 cases, >5 in 27 and >10 in 11 cases. We detected pathological diagnosis in 7 of 16 cases (43.8%) with scalene lymph node biopsy and in all of 15 (100%) cases with mediastinoscopy. We diagnosed sarcoidosis with open lung biopsy in 1 case. Conclusion: In patients clinically and radiologically suspected to have sarcoidosis, since invasive diagnostic methods mostly could reveal histopathological diagnosis, it would be helpful! to use invasive methods.