Characteristics of patients with sarcoidosis that was diagnosed using invasive methods

Sarcoidosis is a multisystem disease of unknown origin that is characterized by formation of granulomas in various organs, predominantly lungs and lymph nodes. The approaches to evaluation and treatment of patients with sarcoidosis are controversial. Differential diagnosis of sarcoidosis is most often carried out with tuberculosis (TB). The aim of the study was to determine the characteristics of patients with sarcoidosis diagnosed using invasive diagnostic methods and assessment of these characteristics for differential diagnosis with tuberculosis. Methods. The medical histories of patients admitted to the thoracic surgery department to verify the diagnosis of sarcoidosis were studied. Videothoracoscopy was chosen to obtain biopsy samples as the safest and the most valuable diagnostic procedure. Sarcoidosis was diagnosed when a characteristic granuloma was detected by pathology. Results. Of the 64 cases, 42 (65.6%) were women and 22 (34.4%) were men. The mean age was 48.4 ± 11.6 years. Of the 64 patients studied, 26 (40.6%) people had a preliminary diagnosis of tuberculosis. In 19 (73.1%) of these cases, tuberculosis was excluded by a tuberculosis specialis, and in 7 (26.9%) cases TB was excluded after the anti-tuberculosis treatment course. Baed on the histology, the most common types of sarcoidosis were pulmonary (30/64, 46.9%) and combined lymph node and pulmonary sarcoidosis 25 (39.1%). Sarcoidosis of the lymph nodes 5 (7.8%) and sarcoidosis of other locations 4 (6.3%) were much less common. The largest group of patients were women with sarcoidosis of the lymph nodes and lungs 20 (31.3%) aged 35–64 years. Conclusion. Diagnosis of sarcoidosis is difficult. When examining a patient with newly identified changes in the lungs and lymph nodes and dissemination syndrome, the anti-tuberculosis treatment not justified in the absence of convincing evidence for tuberculosis, a negative test for HIV infection, in the absence of inflammatory changes in the blood, in the presence of prolonged contact with dust and when the patient is female. Morphological verification of the diagnosis will reduce the time required for diagnosis and eliminate the incorrect prescription of chemotherapy.