Clinical Relevance of Subcentimetric Lymph Node Biopsy in the Diagnosis of Ocular Sarcoidosis

Ocul Immunol Inflamm. 2022 Apr 3;30(3):717-720. doi: 10.1080/09273948.2020.1817503. Epub 2020 Oct 5.

Abstract

Purpose: To evaluate the clinical relevance of subcentimetric lymph node biopsy via mediastinoscopy in patients with presumed ocular sarcoidosis (OS).

Methods: Retrospective study of consecutive patients who underwent biopsy via mediastinoscopy for suspected OS. The biopsy outcomes and clinical features of patients with subcentimetric nodes and of those with lymph nodes >1 cm were compared.

Results: A total of 67 patients with presumed OS were included. Forty-two patients (63%) had lymph nodes ≥1 cm in diameter, while 25(37%) showed subcentimetric lymph nodes. Biopsy was consistent with sarcoidosis in 83% of patients with lymph nodes ≥1 cm and in 76% of patients with subcentimetric lymph nodes (p = .60). Patients with OS who had subcentimetric lymph nodes had less lymphopenia (p = .01), lower lysozyme values (p = .03) and a longer diagnostic delay compared to those with larger lymph nodes.

Conclusions: The biopsy of subcentimetric lymph nodes via mediastinoscopy may provide a histological diagnosis and reduce diagnostic delay.

Keywords: Ocular sarcoidosis; biopsy; mediastinoscopy; sarcoid uveitis.

MeSH terms

  • Biopsy
  • Delayed Diagnosis
  • Endophthalmitis*
  • Humans
  • Lymph Nodes / pathology
  • Retrospective Studies
  • Sarcoidosis* / diagnosis