유육종증 진단에서의 사각근 림프절 생검의 유용성

초록

Background: In addition to clinical and radiographic findings, a histopathologic examination is important in the diagnosis of sarcoidosis. This study evaluated the diagnostic usefulness of a scalene node biopsy in patients with suspected sarcoidosis. Material and Method: We studied 35 patients who underwent scalene node biopsy because of suspicion of sarcoidosis on a chest x-ray and a computerized tomogram between 2001 and 2009, regardless of symptoms. Result: We studied 15 men and 20 women whose mean age was 41.51±11.21 years (25∼64). Three among the 35 were diagnosed with tuberculosis and 27 with sarcoidosis, resulting in a diagnostic yield of 84.4%. The mean lymph node diameter size was 1.3 (±0.12) (0.3∼3.6 cm) cm. We divided the group of participants according to stage - whether on chest x-ray the lung was affected or not (stage 0, 1 and stage 2, 3). We divided lymph node sizes as well - whether they were larger than 1 cm or smaller than 1 cm. For these subgroups,there were no significant differences in diagnostic yield (p=0.604) (p=0.084). There were no complications or mortality. Conclusion: Scalene node biopsies are simply done under local anesthesia, without major complications. They have a high diagnostic yield regardless of the stages of the disease and lymph node size. We conclude that scalene node biopsy is a good alternative to other biopsy methods in sarcoidosis.

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