Objective: To determine the current role of mediastinoscopy in the diagnosis and differential diagnosis of stage I thoracic sarcoidosis.
Methods: The clinical data of 60 patients with a presumptive diagnosis of stage I thoracic sarcoidosis underwent mediastinoscopy from November 1999 to June 2007 were analyzed retrospectively. All the patients had hilum of lung and/or mediastinal lymphadenopathy with normal lung parenchyma on thoracic CT scan. Typical stage I sarcoidosis was defined as presence of bilateral hilum of lung lymphadenopathy with/without mediastinal lymphadenopathy.
Results: All the patients had definitive pathologic diagnosis. Among the 33 patients with typical presentation of stage I sarcoidosis, 32 patients were confirmed by pathology. One patient was reactive lymph node. Among the 27 patients with atypical patterns on CT, 17 patients were confirmed by pathology. No postoperative complication and mortality occurred.
Conclusion: For the patient with a presumptive diagnosis of typical stage I thoracic sarcoidosis after clinical and radiological evaluation, confirmation of the diagnosis by mediastinoscopy and lymph node biopsy is unwarranted.