Abstract
Transbronchial lung biopsy (TBLB) was performed 112 times in 108 patients suspected of sarcoidosis. TBLB revealed noncaseating granulomas in 92 of the 112 examinations (82%).
The analysis of the ratio of positive biopsies between the upper lobe and the lower lobe was made in terms of the roentgenographic stage of sarcoidosis. Positive biopsies were obtained in 15 of 43 (34.9%) specimens from the upper lobe, and in 3 of 45 (6.7%) from the lower lobe with roentgenographic stage O disease, in 37 of 90 (41.1%) from the upper lobe, and 29 of 120 (24.2%) from the lower lobe with stage I disease, in 69 of 93 (74.2%) from the upper lobe, and in 43 of 88 (48.9%) from the lower lobe with stage II disease, and in 11 of 16 (68.8%) from the upper lobe and in 11 of 18 (61.1%) from the lower lobe with stage III disease. The proportion of positive biopsies from the upper lobe was significantly higher than that from the lower lobe except for stage III disease. From these results, it may be concluded that noncaseating granulomas of sarcoidosis appear preferentially in the upper lobe. For this reason, it may be necessary to obtain more biopsy specimens from the upper lobe by TBLB in cases of sarcoidosis. This might increase the ratio of positive biopsies by TBLB in this disease.
