Endoscopic findings in sarcoidosis. Characteristics and correlations with radiographic staging and bronchial mucosal biopsy yield.

Flexible fiberoptic bronchoscopy was performed in 101 patients with sarcoidosis, and the endoscopic findings were analyzed and correlated with radiographic stages and diagnostic bronchial biopsy. Endoscopic findings included bronchostenosis (26% of patients), mucosal nodularity (64%), hypervascularity (38%), and mucosal edema (55%). The only correlation between these findings and the radiographic stage was the presence of mucosal nodularity observed in 73% of stage I (14/19 patients), decreasing to only 48% in stage III (15/31 patients). Bronchial biopsy yield was 58% for stage I, 62% for stage II, and 46% for stage III, with overall yield of 57%. However, the addition of bronchial biopsies increased the diagnostic yield of the bronchoscopic procedure from 73% for transbronchial biopsies alone to 88% when the two procedures were combined. In the presence of endobronchial stenosis, mucosal nodularity and hypervascularity, bronchial biopsy yield was 91% vs 37% when these were absent. We conclude that the endoscopic characteristics, with the exception of nodularity, do not correlate with radiographic stages. Bronchial biopsy yield is higher in those patients with mucosal nodularity, increased vascularity, and bronchostenosis. Bronchial mucosal biopsy also improved the overall diagnostic yield when it is obtained in conjunction with transbronchial lung biopsy.