lung and airway disorders
Sarcoidosis
Diagnosis of Sarcoidosis
Chest imaging Biopsy Doctors most often suspect sarcoidosis when they observe its distinctive changes, including enlarged lymph nodes and abnormal findings on a chest x-ray or on computed tomography (CT). Further testing is necessary, typically microscopic examination of a tissue sample (biopsy) from the affected organ showing inflammation and granulomas, to confirm the diagnosis. Bronchoscopy with ultrasound-guided needle biopsy is 90% accurate and is the preferred procedure for people whose lungs are involved. Other possible sources of tissue specimens are skin abnormalities, enlarged lymph nodes close to the skin, and granulomas on the conjunctiva. A liver biopsy is generally not done because liver granulomas can be caused by other disorders and so the biopsy may not provide a definite diagnosis. Cardiac magnetic resonance imaging (MRI), brain or spine MRI, bone scans, and electromyography may be done in people with symptoms related to those organ systems. Tuberculosis (TB) can cause many changes similar to those caused by sarcoidosis. Therefore, doctors also do a tuberculin skin test (and sometimes a lung biopsy) to help determine whether the problem is tuberculosis or sarcoidosis. Other methods that can help doctors diagnose sarcoidosis or assess its severity include irrigating the lungs ( Procedures Done With Bronchoscopy ) and examining the fluid. The fluid from a lung with active sarcoidosis contains a large number of In people with lung scarring, Pulmonary Function Testing (PFT) may show that the amount of air the lungs can hold is below normal. A 6-minute walk test may be done to help determine how severely the lungs are affected. Blood tests may reveal a low number of white blood cells, red blood cells, or, rarely, platelets. Immunoglobulin levels are often high, especially in Black people. Levels of calcium in the blood or urine may be high. The levels of liver enzymes, particularly alkaline phosphatase, may be high if the liver is affected. 