Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine

Mount Sinai Sarcoidosis Support Group

Patient/Family Information

Diagnosis

definite diagnosis of sarcoidosis requires a biopsy (sample of tissue) which shows a granuloma without evidence of germs or particles which can cause granulomas (TB, fungus, silica) or a positive skin test called the Kveim-Siltzbach test.

What does that mean? As a result of diagnostic procedures, patients are told that their diagnosis is consistent with sarcoidosis. Since the actual cause is still unknown, tests are conducted to eliminate the possibility of diseases other than sarcoidosis. Technically, tests will show the presence of granulomas, groups of cells that under a microscope resemble a granule. Other diseases are associated with granulomas, but in these diseases other particles can also be seen through the microscope inside the granulomas. When sufficient granulomas are found in an area of the body, lumps or bumps may appear. When an organ is involved, its functioning may be impaired and symptoms may appear. Treatment may be indicated, with duration sometimes lengthy. Unfortunately, in some cases granulomas may become scar tissue that can interfere chronically with the functioning of organs.

Diagnostics

Once your diagnosis is confirmed, you should have additional tests which tell the doctor the extent of the illness, if the illness needs treatment, and the results of treatment. Routine tests usually include a chest x-ray, pulmonary function testing, and blood analysis. The x-ray will show the progress of the disease within the lungs. The pulmonary function tests measure airflow and lung volume. Since the lungs are most often involved, comparative test results show the impact on your breathing. A blood sample may be taken to measure arterial blood levels for oxygen and carbon dioxide. Additionally, patients with sarcoidosis should have their blood and urine calcium levels monitored, since patients may have elevated levels that may cause kidney difficulties. Other tests may be ordered as necessary.