Cytological investigation of biopsy performed in sarcoidosis

One of the most frequent appearance of sarcoidosis is the enlargement of mediastinal lymph-nodes. The clinical picture first of all must be distinguished from the malignant processes and seldom from lymph-node tuberculosis. At our clinic material was obtained for cytological examination in two ways: through mediastinoscopy in the course of which we had opportunity of histological evaluation too and by means of transbronchial thin-needle puncture respectively and only cytological examination was performed with this material. We carried out investigations in 155 patients sent to our clinic on account of the suspicion of sarcoidosis. According to the course of disease or rather other examinations 123 out of 155 patients suffered from sarcoidosis and in 112 of these cases that is in 91% the diagnosis was verified by the help of cytological examination. In the smears epithelioid cell groups were generally found in large number but Langhans' giant cells could be produced only in 21 cases. In 70 of 123 patients mediastinoscopy and in 53 transbronchial thin-needle biopsy was accomplished. Through cytological investigation of material obtained mediastinoscopically we attained nearly 100% positivity rate and 80% by the help of thin-needle biopsy. Although forasmuch as the transbronchial puncture does not need special intervention because it can be carried out in the course of routine bronchoscopy we think the application of the procedure reasonable not only in finding metastasis if it involves the hypertrophy of mediastinal lymph-nodes. In this way we spare the patient from further examinations. The cytological finding, of course, must be always fitted in clinical picture but on the basis of our experience the close cooperation between the clinician and cytologist assures the avoidance of wrong diagnosis.