How is sarcoidosis diagnosed?
Do you have to be in the hospital?
Can your family doctor treat sarcoidosis?
Is sarcoidosis contagious?
Is sarcoidosis inherited?
Can children develop sarcoidosis?
Does cigarette smoking cause sarcoidosis?
Can sarcoidosis occur from the workplace or the environment?

How is sarcoidosis diagnosed?

The approach to the diagnosis of sarcoidosis is in constant change. It depends on the clinical situation and varies from patient to patient.

In general, if a person has moderate to severe symptoms or treatment is going to be given, tissue diagnosis is recommended. This means that a biopsy is necessary. The most accessible area that requires the least invasive procedure is usually recommended.

If there is an enlarged lymph node that is easily accessible, this will be biopsied. If the process is in the lung, a lung biopsy will be obtained. This procedure can be performed by a video-assisted thoracoscopy (VAT) on a day surgical basis or in the hospital. A small chest tube is required for 24 to 72 hours after the procedure. Since sarcoidosis may first manifest itself in the skin especially overlying the lower legs (erythema nodosum), the lymph nodes, or the eyes, biopsies of other organ systems may be recommended.

Because of the variable approach to the diagnosis of sarcoidosis, it is important to understand the details of the diagnostic approach you have been given.

The following information is useful in discussing the diagnosis with your doctors. What is the diagnostic test or procedure? Is it a biopsy? What type of biopsy is it? Where is the biopsy going to be obtained? How long will it take? Is it a day surgical procedure? What are the risks of the procedure? What is the meaning of a positive test? What if this test or procedure is negative or shows a nonspecific result? What are the alternative approaches?

In certain situations, ask about a period of observation and deferring the biopsy. What are the other diagnoses under consideration, and what are the risks of observation?

For example, if there is moderate to severe shortness of breath, an abnormal diffusion pulmonary function test, and a chest x-ray showing small tiny nodules, a lung biopsy may be the best approach because treatment is probably going to be needed. If enlarged lymph nodes in the middle of the chest (the hilar region) are discovered from a routine chest x-ray in a 25 year old person with no symptoms, close observation may be the best approach.