Poe R H, Israel R H, Utell M J, Hall W J
Arch Intern Med. 1979 Jul;139(7):761-3.
Forty-one consecutive patients with suspected sarcoidosis underwent pulmonary function testing and transbronchial lung biopsy at three community teaching hospitals. Transbronchial biopsy disclosed noncaseating granulomas in 22 of 23 patients (96%) in whom parenchymal disease was roentgenographically apparent and in eight of 18 patients (44%) in whom it was not. The stage of the disease as determined by the chest roentgenogram was the most reliable determinant for a positive biopsy result. Not the presence of cough, dyspnea, or constitutional symptoms or pulmonary function as measured by forced vital capacity and carbon monoxide diffusing capacity served to predict a positive transbronchial biopsy finding any more accurately than did the roentgenographic staging of the disease itself. This study suggests that while transbronchial lung biopsy may be an acceptable initial diagnostic procedure in suspected sarcoid patients without parenchymal lung disease, clinical symptoms and pulmonary function abnormalities are not helpful in predicting the liklihood of a positive biopsy result.
41例连续的疑似结节病患者在三家社区教学医院接受了肺功能测试和经支气管肺活检。在23例胸部X线片显示有实质性病变的患者中，经支气管活检发现22例（96%）有非干酪样肉芽肿；在18例胸部X线片未显示实质性病变的患者中，8例（44%）有非干酪样肉芽肿。胸部X线片所确定的疾病分期是活检结果呈阳性的最可靠决定因素。咳嗽、呼吸困难、全身症状的存在与否，或用力肺活量和一氧化碳弥散量所测定的肺功能，都不比疾病本身的X线分期更能准确预测经支气管活检结果呈阳性。这项研究表明，虽然经支气管肺活检对于没有实质性肺部疾病的疑似结节病患者可能是一种可接受的初始诊断方法，但临床症状和肺功能异常无助于预测活检结果呈阳性的可能性。
