Transbronchoscopic lung biopsy in sarcoidosis.

In a prospective study in our department, 63 consecutive patients with suspected sarcoidosis underwent combined bronchial and transbronchial biopsy during bronchoscopy with rigid instruments under general anaesthesia. Lung tissue was obtained in all cases. In 19 cases noncaseous granulomas were found only by transbronchial lung biopsy. In 9 cases they were found only by bronchial biopsy. In 30 patients noncaseating granulomas were found by both technics, that is, the lesions were found in both lung parenchyma and bronchial wall. In 5 patients, diagnosis of sarcoidosis could not be confirmed by bronchological methods, but was obtained by other biopsy procedures. From our findings, we conclude that the combination of bronchial and transbronchial biopsies during bronchoscopy with rigid instruments is a valuable procedure for establishing the diagnosis of sarcoidosis and that the bronchological methods could replace mediastinoscopy in most cases of sarcoidosis.