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The diagnosis of sarcoidosis

Judson, Marc A.

Current Opinion in Pulmonary Medicine: September 2019 - Volume 25 - Issue 5 - p 484–496
doi: 10.1097/MCP.0000000000000596
SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson

Purpose of review To review the diagnostic approach to sarcoidosis. There is no gold standard diagnostic test, procedure or algorithm for sarcoidosis. The diagnosis is based on a compatible clinical presentation, histologic findings of granulomatous inflammation, exclusion of alternative diseases, and evidence of systemic involvement. Occasionally, there may be exceptions to several of these requirements.

Recent findings The diagnostic specificity of several specific clinical features are discussed. Typical histologic findings of sarcoidosis are described. Several diseases that may mimic sarcoidosis are reviewed.

Summary The diagnosis of sarcoidosis usually involves weighing the clinical evidence for and against the diagnosis, coupled in most cases with histologic evidence of granulomatous inflammation. This approach requires knowledge of the varied presentations of the disease and other alternative conditions as well as histologic examination of an affected tissue in most instances.

Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, New York, USA

Correspondence to Marc A. Judson, MD, Division of Pulmonary and Critical Care Medicine, MC-91, Albany Medical College, Albany, NY 12208, USA. E-mail:

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