ヒロシマ　ケンゾウ   HIROSHIMA Kenzou   廣島　健三    所属   医学部 医学科（附属八千代医療センター）    職種   登録医
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Feasibility of cytological diagnosis of sarcoidosis with endobronchial US-guided transbronchial aspiration.
掲載誌名	正式名：Sarcoidosis, vasculitis, and diffuse lung diseases 略　 称：Sarcoidosis Vasc Diffuse Lung Dis ISSNコード：1124-0490(Print)1124-0490(Linking)
巻・号・頁	29(2),pp.82-9
著者・共著者	Kitamura A†, Takiguchi Y, Kurosu K, Takigawa N, Saegusa F, Hiroshima K, Nakajima T, Tanabe N, Nakatani Y, Yoshino I, Tatsumi K
発行年月	2012/10
概要	BACKGROUND:Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has a high diagnostic value in sarcoidosis if the obtained histological specimen is indicative of a non-caseating epithelioid-cell granuloma. However, EBUS-TBNA in sacoidosis sometimes affords solely cytological specimens.OBJECTIVE:To investigate the relevance of EBUS-TBNA cytology specimens in diagnosing sarcoidosis.DESIGN:The study population comprised 72 patients with sarcoidosis and 116 patients who had thoracic malignancies and intrathoracic lymphadenopathy but were eventually proven toDESIGN:be metastasis-free (controls). The EBUS-TBNA samples obtained for these subjects were blindly evaluated for the presence of epithelioid cell clusters by 2 independent cytoscreeners and a pathologist.RESULTS:Interobserver variability in the specimen grading was minimal. The sensitivity and specificity were 65.3% and 94.0%, respectively. The sensitivity was high, at 87.5%, for the combined cytological and histological examinations. Of 7 controls whose cytological specimens showed epithelioid cell clusters, 3 were also deemed positive for sarcoidosis on histological examination, which indicated that they had sarcoid reaction to cancer.CONCLUSIONS:Cytological evaluation of the EBUS-TBNA specimens had higher sensitivity than histological evaluation alone for intrathoracic lymphadenopathy due to sarcoidosis. It should be recognized, however, that up to 6% of patients with thoracic malignancy may have sarcoid reaction in non-metastatic lymph nodes.
文献番号	23461069