Vrednost transbronhijalne aspiracione citologije u dijagnozi sarkoidoze stadijuma I i II

  • Željka Tatomirović Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Vesna Škuletić Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Dragana Peković Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Vukoica Karličić Military Medical Academy, Clinic for Pulmonary Disease, Belgrade, Serbia.
  • Branka Djurović Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Institute for Occupational Medicine, Belgrade, Serbia.
  • Saša Ristić Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia.
  • Ljiljana Tomić Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia.
  • Jelena Džambas Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia.
  • Snežana Cerović Military Medical Academy, Institute for Pathology and Forensic Medicine, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP151105080T
Ključne reči: sarcoidosis||, ||sarkoidoza, diagnosis||, ||dijagnoza, diagnosis, differential||, diferencijalna, lymph nodes||, ||limfni čvorovi, mediastinum||, ||medijastinum, biopsy, fine-needle||, ||biopsija tankom iglom, sensitivity and specificity||, ||senzitivnost i specifičnost,

Sažetak


Uvod/Cilj. Sarkoidoza je multisustemsko oboljenje nepoznate etiologije koje najčešće zahvata pluća i intratorakalne limfne čvorove. Cilj ovog rada bio je da se proceni doprinos konvencionalne transbronhijalne aspiracione (TBNA) citologije u dijagnozi sarkoidoze prikazane kao medijastinalna/hilarna adenopatija. Metode. U ovoj retrospektivnoj studiji, na 58 bolesnika sa sumnjom na stadijum I i II sarkoidoze urađena je prvo fleksibilna bronhoskopija, a potom, u toku rigidne bronhoskopije, TBNA medijastinalnih ili hilarnih limfnih čvorova iglom od 19 gejdža (G). Materijal iz igle je istisnut na predmetno staklo i pripremljen za citološku i patohistolosku dijagnostiku. Rezultati. Od 58 bolesnika kojima je urađena TBNA medijastinalnih ili hilarnih limfnih čvorova, kod 53 (91,37%) dobijen je adekvatan material za citološku dijagnostiku. Od 53 adekvatna citološka uzorka, kod 38 (71,69%) nađena je nekazeozna granulomatozna inflamacija (NGI), dok je u odgovarajućim patohistološkim uzorcima NGI nađena kod 48 (90,56%), što je bio statistički značajno veći broj (p < 0,05). U citološkim uzorcima, od ćelija tipičnih za granulomatoznu inflamaciju, u uzorcima 26 (63,15%) bolesnika nađene su nakupine epiteloidnih ćelija, kod 8 (21,05%) uz nakupine epiteloidnih ćelija nađeni su i džinovski multinuklearni histiociti, a kod 6 (15,76%) samo pojedinačne epiteloidne ćelije ili male grupe od po nekoliko epiteloidnih ćelija. Senzitivnost TBNA citologije u našoj grupi bolesnika sa sarkoidozom bila je 76%, specifičnost 100% i tačnost 77,34%. Zaključak. Metoda TBNA je efikasna i sigurna za dijagnozu sarkoidoze, minimalno invazivna i s malim rizikom od komplikacija. Upotrebom igle od 19 G dobija se materijal i za citološku i za histološku analizu. Vrednost ovog tipa dijagnostike zavisi od obučenosti i iskustva kako pulmologa koji uzima materijal, tako i od citologa i patologa koji taj materijal interpretitraju.

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Objavljeno
2017/07/07
Broj časopisa
Vol. 74 Br. 6 (2017)
Rubrika
Originalni članak