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DOI: 10.1055/s-0030-1262207
Diagnostic Modalities in Sarcoidosis: BAL, EBUS, and PET
Publication History
Publication Date:
27 July 2010 (online)
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ABSTRACT
Advances have been made in minimally invasive diagnostic procedures in sarcoidosis, including bronchoalveolar lavage (BAL), endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), and positron emission tomography (PET). Several independent groups found almost identical predictive values of the CD4:CD8 ratio in BAL for the diagnosis of sarcoidosis. A CD4:CD8 ratio greater than 3.5 shows a high specificity of 93 to 96% for sarcoidosis, but the sensitivity is low (53 to 59%). EBUS-TBNA is a safe and useful tool for diagnosing sarcoidosis stage I and II with a sensitivity of 83 to 93% and a specificity of 100%. Novel imaging techniques have been explored, such as PET using L-[3-18F] fluoro-α–methyltyrosine (18F-F MT), which is more specific for malignancy than 18F-fluorodeoxyglucose (18F-FDG)-PET. The combined modality of FMT-PET with FDG-PET could successfully discriminate sarcoidosis from malignancy. These recent developments including novel biopsy procedures and novel imaging techniques could be of value to diagnosing sarcoidosis.
KEYWORDS
Bronchoalveolar lavage (BAL) - endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) - positron emission tomography (PET) - sarcoidosis - diagnosis
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Ulrich CostabelM.D.
Ruhrlandklinik, Tueschener Weg 40
D-45239 Essen, Germany
Email: ulrich.costabel@ruhrlandklinik.uk-essen.de