Identification of specific EBUS-TBNA sonographic characteristics for differentiating sarcoidosis from tuberculosis and lymphoma

Background: We hypothesized that specific sonographic features on endobronchial ultrasonography (EBUS) may differentiate sarcoidosis from other lymph nodes. In current study, the sonographic features of sarcoidosis, lymphoma and tuberculosis lymph nodes were compared. Methods: We conducted a retrospective observational study to analyze the patients with intrathoracic lymphadenopathy who underwent EBUS-guided transbronchial needle aspiration (TBNA). Sonographic features such as nodal size, margin, echogenicity, and presence or absence of calcification, a central hilar structure, coagulation necrosis sign, intranodular vascularity, and nodal conglomeration were recorded and compared in the 3 groups. Results: During the study period, a diagnosis of tuberculosis (n=9), sarcoidosis (n=53), and lymphoma (n=9) was made in 71 patients by EBUS-TBNA. Presence of nodal conglomeration (98.1% versus 88.9% versus 11.1 %, P Conclusions: The presence of nodal conglomeration, and intranodular vascularity, and absence of coagulation necrosis in the lymph nodes on EBUS are predictive of sarcoidosis.