[Diagnosis of sarcoidosis by bronchial biopsy and transbronchial pulmonary biopsy]

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.