tissue diagnosis in sarcoidosis
Last reviewed 01/2018
Presence of noncaseating granulomas on tissue biopsy (together with compatible clinical and radiographic presentation) is necessary for the diagnosis of sarcoidosis in most patients.
Exceptions are patients with Lofgren syndrome and asymptomatic patients with symmetrical bilateral lymphadenopathy on chest radiography) (1,2)
Common sites to obtain a sample include the skin, peripheral nodes, lacrimal glands and conjunctiva.
In case of lung involvement bronchoscopy with biopsy of central (endobronchial) and peripheral (transbronchial) airways is useful (1).
It is important to remember that noncaseating granulomas are non specific and are not diagnostic of sarcoidosis.
Some granulomatous conditions which may mimic sarcoidosis include: lymphoma, mycobacterial infections (notably tuberculosis), and fungal infections (1)
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