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Endoscopy 1999; 31(5): 377-382
DOI: 10.1055/s-1999-32
Short Communication
Georg Thieme Verlag Stuttgart · New York

Endoscopic Ultrasonography with Fine-Needle Aspiration: An Accurate and Simple Diagnostic Modality for Sarcoidosis

 G. Mishra 1 ,  A.V. Sahai 1 ,  I. D. Penman 1 ,  D. B. Williams 1 ,  M. A. Judson 2 ,  D. N. Lewin 3 ,  R. H. Hawes 1 ,  B. J. Hoffman 1
  • 1 Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA 2 Division of Pulmonary and Critical Care, Medical University of South Carolina, Charleston, South Carolina, USA 3 Dept. of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA
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Publication Date:
31 December 1999 (online)

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Introduction

Endoscopic ultrasonography (EUS) is an established imaging technique that is now accepted as the most accurate method for locoregional tumor staging in gastrointestinal malignancies [1] [2] [3]. Until recently, computed tomography (CT) scanning was the primary method for imaging these neoplasms. There have been numerous reports showing that endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) is the most accurate nonsurgical method for detecting posterior mediastinal lymph nodes [4] [5]. Sarcoidosis is a chronic systemic disease that is characterized by noncaseating granulomas. The prevalence of sarcoidosis ranges from less than one case to 40 cases per 100 000, with an age-adjusted annual incidence rate in the United States of 10.9 per 100 000 for whites and 35.5 per 100 000 for blacks [6].

Its presentation varies from pulmonary involvement, with shortness of breath, to gastrointestinal involvement, with severe dysphagia [7] [8]. The diagnosis of sarcoidosis is often clinical, but it can also be corroborated by using laboratory tests such as angiotensin-converting enzyme (ACE) levels, or by histological confirmation using either transbronchial biopsy forceps or a Wang transbronchial needle via a fiberoptic bronchoscope [9].

Several large published series on EUS-FNA of mediastinal lymph nodes mention sarcoidosis as a diagnosis in their specimens [4] [5]. However, to our knowledge, no single paper has described the value of EUS with FNA for diagnosing sarcoidosis in detail. The present case series not only highlights the feasibility of EUS-directed FNA in the diagnosis of sarcoidosis, but also describes some salient endosonographic features suggestive of sarcoidosis.

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G. MishraM.D. 

Gastroenterology, Hepatology, and Nutrition

University of Florida

P.O. Box 100214

Gainesville, FL 32610

USA

Phone: + 1-352-392-3618

Email: mishrag@medicine.ufl.edu

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