Austgen M, Feidt H, Trendelenburg F
Rev Pneumol Clin. 1984;40(3):161-5.
The presence of non-caseating epitheloid cell granulomas in biopsy material is still one of the most important factors in establishing the diagnosis of sarcoidosis. Since Carlens introduced mediastinoscopy as a diagnostic procedure in these cases the use of liver biopsy or bronchoscopic biopsy has decreased because of the better results obtained by mediastinoscopy. In 148 of 163 persons with sarcoidosis the diagnosis could be verified by the finding of epitheloid cell granuloma without central necrosis in biopsies taken from the lungs and/or bronchial wall. In 15 patients the diagnosis could not be confirmed by bronchological methods, but the presence of epitheloid cell granulomas was established by other biopsy procedures. The conclusions drawn from the observations are that the combination of bronchial and transbronchial biopsies during bronchoscopy with rigid instruments is a valuable technique for establishing the diagnosis of sarcoidosis and that bronchological methods could replace mediastinoscopy in most cases.
活检材料中存在非干酪样上皮样细胞肉芽肿仍是确立结节病诊断的最重要因素之一。自从卡伦斯将纵隔镜检查引入这些病例的诊断方法以来，由于纵隔镜检查取得了更好的结果，肝活检或支气管镜活检的使用有所减少。在163例结节病患者中，有148例通过在肺和/或支气管壁活检中发现无中央坏死的上皮样细胞肉芽肿得以确诊。15例患者经支气管学方法未能确诊，但通过其他活检程序确定存在上皮样细胞肉芽肿。从这些观察结果得出的结论是，在硬式器械支气管镜检查期间联合进行支气管活检和经支气管活检是确立结节病诊断的一种有价值的技术，并且在大多数情况下支气管学方法可以替代纵隔镜检查。
