الفهرس 
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Abstract
Background: Sarcoidosis is defined as a granulomatous inflammatory disorder of idiopathic cause that can affect multisystem. Sarcoidosis affects the lung in more than 90% of cases but also can affect any organ of the body. For most cases the disease is self-limited and resolves within 2 to 5 years. However, a chronic form of the disorder may lead to significant morbidity and some mortality.
Sarcoidosis can affect people of different age groups throughout the world, with the highest incidence in those between 20 and 40 years’ old. Worldwide, women count for most of the cases. The etiology of sarcoidosis remains unclear; however, there is increasing knowledge of its genetic factors, environmental correlations, assumed antigens and immunopathogenesis, and it mostly results from the exposure of genetically susceptible individuals to certain environmental agents.
The mechanisms by which the airways are involved in sarcoidosis are various. The anatomic anomalies caused by sarcoidosis may or may not lead to pulmonary symptoms or physiologic changes. The initial gross mucosal abnormality is the airway inflammation manifested by mucosal edema, erythema, and the formation of granulomas. As the airway disease progresses, the mucosa may show granularity, nodularity, friability and cobblestoning.
Sarcoidosis is usually diagnosed by a survey of clinical data, histologic evaluation of tissue for the presence of granuloma, and exclusion of other causes of granulomatous inflammation. The bronchoscope allows for several different samples, including the transbronchial biopsy (TBB), endobronchial biopsy (EBB), and transbronchial needle aspiration (TBNA). Bronchoscopists often underestimate the value of endobronchial biopsy (EBB) in the histological confirmation of sarcoidosis. In the presence of bronchial mucosal changes including nodularity, hyperemia, EBB was found to be diagnostic in over 90% of cases. Even when there are no mucosal abnormalities, a positive biopsy may be obtained in about 30% of cases.
Aim of the study: our aim of the study was to identify endobronchial gross mucosal changes in patients with pulmonary sarcoidosis and to detect the diagnostic yield of endobronchial biopsy.
Methods: 20 patients with suspected pulmonary sarcoidosis by clinical and radiological evaluation were recruited for this study. All subjects undergone full history taking, clinical examination, routine lab investigations and radiological evaluation including CT chest with iv contrast. The bronchoscopy procedure was performed by two experienced bronchoscopists. Any abnormal endoscopic findings suggestive of endobronchial sarcoidosis were reported by the operators. Broncho-alveolar lavage (BAL) was obtained by endoscopic injection of at least 120 cc of sterile saline then suction of the whole possible yield. The operator obtained four endobronchial biopsies from the described findings plus two other biopsies from the main carina. In absence of mucosal abnormalities, four speci