Prevalence and Diagnostic Accuracy of Cervical Lymphadenopathy in Sarcoidosis: Insights from Ultrasound-Guided Biopsies

<bold>Objective:</bold> To assess the prevalence of cervical lymphadenopathy (LNs) in sarcoidosis, their sonographic features and the diagnostic accuracy of ultrasound (US)-guided cervical LN Core needle biopsies CNB. <bold>Methods:</bold> a prospective study from January to December 2023, 40 patients upon clinico-radiological data were suspected of sarcoidosis and underwent cervical US assessment by trained respiratory physician in the ultrasound unit of the tertiary respiratory center. For patients with cervical LNs, full sonographic features were recorded before US-guided CNB, the obtained biopsies were sent for histopathological and microbiological examination. while others pursued organ-specific diagnostic modalities. Patients diagnosed with a disease other than sarcoidosis were excluded, ensuring a focused study on sarcoidosis. <bold>Results:</bold> In 40 patients with confirmed sarcoidosis, cervical LNs were detected in 55% (22 patients) by US. Sonographic features are in Table 1. Among the 22 patients, 21 underwent US-guided CNB. All 21 patients were confirmed sarcoidosis based on histopathological findings of non-caseating granulomas and negative TB cultures, excluding all alternative causes. <bold>Conclusion:</bold> Based on our findings, the prevalence of cervical LNs at 55% in sarcoidosis and the 100% diagnostic accuracy of US-guided CNB by respiratory physicians, we suggest routine cervical US assessment for suspected sarcoidosis cases.