Endosonographic nodal aspiration provides “greater diagnostic yield” in patients with suspected stage I/II pulmonary sarcoidosis undergoing confirmation of the condition via tissue sampling, according to research appearing in the June 19 issue of JAMA.

“For patients who require tissue sampling either to confirm sarcoidosis before treatment or to exclude similar presenting diseases such as tuberculosis and lymphoma, the outcomes of this study indicate that endosonographic evaluation is likely to have the highest diagnostic yield,” the authors concluded.

For the randomized trial, 304 patients with suspected pulmonary sarcoidosis (stage I/II) in whom tissue confirmation of noncaseating granulomas was indicated, underwent either bronchoscopy with transbronchial and endobronchial lung biopsies or endosonography (esophageal or endobronchial ultrasonography) with aspiration of intrathoracic lymph nodes.

Granulomas were found significantly more often at endosonography (74%) than bronchoscopy (48%). The diagnostic yield to detect granulomas for endosonography compared to bronchoscopy was 80% and 53%, respectively.

For stage I sarcoidosis, the diagnostic yield of bronchoscopy was 38 percent compared with 66 percent for stage II, according to the authors. For endosonography, diagnostic yield for stage I was 84 percent compared with 77 percent for stage II.