The Diagnosis of Sarcoidosis

Clin Chest Med. 2015 Dec;36(4):585-602. doi: 10.1016/j.ccm.2015.08.003. Epub 2015 Oct 9.

Abstract

Sarcoidosis is a diagnosis of exclusion; there exists neither a pathognomonic clinical feature nor a perfect diagnostic test. Missed diagnosis and overdiagnosis are common. A careful history and physical examination look for "footprints" of sarcoidosis or features suggesting alternative diagnoses. Some presentations are classic and do not require tissue confirmation. A tissue biopsy should be performed if doubt exists. Sampling intrathoracic disease by transbronchial or ultrasound-guided biopsy of mediastinal lymph nodes provide high diagnostic yield with low complication rates. Even with tissue confirmation, diagnosis is never secure and follow-up is required to be fully confident of the diagnosis.

Keywords: Biopsy; Differential diagnosis; Heerfordt syndrome; Hilar adenopathy; Lofgren's syndrome; Organ involvement; Sarcoidosis.

Publication types

  • Review

MeSH terms

  • Biopsy / methods*
  • Diagnosis, Differential
  • Humans
  • Lymph Nodes / pathology
  • Sarcoidosis / diagnosis*