You Jee Young, Ribeiro Neto Manuel L
Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
Respir Med Case Rep. 2024 Nov 29;53:102146. doi: 10.1016/j.rmcr.2024.102146. eCollection 2025.
Sarcoidosis is a rare chronic granulomatous disease with unknown etiology. Definite diagnosis of cardiac sarcoidosis (CS) is especially difficult to establish. Several guidelines exist to make a diagnosis of CS but those have not been clinically validated. Despite the high specificity of endomyocardial biopsy, its sensitivity is low, and the severity of potential complications is high. Thus, we present 63-year-old male who was diagnosed with CS with the endobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA) of intrathoracic lymph nodes which were non-enlarged without PET avidity. EBUS TBNA of radiographically normal appearing lymph nodes showed non-necrotizing granulomas. Given challenges of diagnosing CS, EBUS TBNA can be considered even in cases without obvious evidence of active pulmonary sarcoidosis.
结节病是一种病因不明的罕见慢性肉芽肿性疾病。心脏结节病（CS）的确切诊断尤其难以确立。现有多项诊断CS的指南，但这些指南尚未经过临床验证。尽管心内膜活检具有高度特异性，但其敏感性较低，且潜在并发症的严重程度较高。因此，我们报告了一名63岁男性，通过支气管内超声（EBUS）经支气管针吸活检（TBNA）对未增大且无PET亲和力的胸内淋巴结进行检查，诊断为CS。对影像学表现正常的淋巴结进行EBUS TBNA显示为非坏死性肉芽肿。鉴于CS诊断存在挑战，即使在没有明显活动性肺结节病证据的情况下，也可考虑进行EBUS TBNA。
