Histologic diagnostic rate of cardiac sarcoidosis: Evaluation of endomyocardial biopsies☆,☆☆,★
Section snippets
Patients
The study was composed of 26 Japanese patients (4 men and 22 women, 28 to 74 years of age, mean 56.3 ± 9.2 years; Table I).
Patient No. Age (y) Sex Lymphadenopathy TB ACE Lys. Biopsy Eye involvement Uptake on 67Ga citrate Pathologic diagnosis group (n = 14) 1 54 F BH, med (–) 21.6 14.2 (+Lung) None NP 2 44 F BH (–) 37.6 NP (+Lung) None BH, med, rt lung field 3 53 F None (–) 61.5 NP (+Skin) Uveitis NP 4 56 F BH, bilat. supCF (–) 26.1 NP (+Lung) None Lt hilum, med, lt parietal, bilat supCF 5 45 F Rt hilum, lt groin (–) 14.8 NP
Results
Noncaseating granulomas were found in only 5 (19.2%) of the 26 cases, thus permitting a histologic diagnosis of cardiac sarcoidosis. Such granulomatous lesions were found in only 9 (8.6%) of the total of 105 biopsy specimens. A histologic diagnosis was made in 4 (36.4%) of 11 patients who showed a DCM-like clinical picture in contrast to only 1 (6.7%) of 15 patients with conduction disturbances as the major clinical feature and an LVEF within the normal limit. However, the difference between
Discussion
A definitive diagnosis of cardiac sarcoidosis requires the histologic examination of tissue specimens obtained by cardiac biopsy. However, in clinical practice, relatively few cases are definitively diagnosed according to histologic evaluation of cardiac biopsy specimens. As a result, steroid therapy is frequently initiated in the absence of any histologic proof.
Sekiguchi et al6 determined the rate of a positive histologic diagnosis by performing sham cardiac biopsies at 10 sites in each of 7
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Cited by (0)
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From the Department of Internal Medicine, Fujita Health University School of Medicine, and the Cardiovascular Center, Nagoya Dai-ni Red Cross Hospital.
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Reprint requests: Shin-ichiro Morimoto, MD, Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kustukake-cho, Toyoake, Aichi, 470-1192 Japan.
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