Because the symptoms may occur in other diseases and there is no single lab test that can diagnose the disease, diagnosis of sarcoidosis may be difficult. Further, determining the presence of granulomas isn’t enough, as they do not differ from granulomas that occur in other diseases. Diagnosis is typically achieved following a careful evaluation by clinicians with experience in diagnosis, and often includes the following tests:
Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.
Personal and family medical history
Your doctor will likely ask you a series of questions relating to your personal medical history and your family's medical history.
Doctors may perform one or more of the follow imaging tests: Bone x-rays, CT scan, MRI, PET scan.
Pulmonary Function Test (PFT)
To understand how well your lungs are working, your physician may order a series of pulmonary function tests. With each breath you take in and breathe out, information is recorded about how much air your lungs take in, how the air moves through your lungs and how well your lungs deliver oxygen to your bloodstream.
Surgical (excisional) lymph node biopsy
The physician removes an enlarged lymph node through a small cut in the skin. If the lymph node is close to the surface of the skin, a local anesthetic will be used to numb the area being biopsied. If it is located deep under the skin, you may be given drugs to make you drowsy or be put to sleep (using general anesthesia). Surgical lymph node biopsies are generally performed if the lymph node’s size indicates the melanoma has spread, but an FNA was not performed or did not yield conclusive results.
Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells. The doctor will use a general or local anesthetic depending on the location of the mass, and then remove a sample of tissue to send to the lab. The sample is sent to a pathologist, a physician who is an expert at identifying diseased cells in tissue samples. Very often, a few stiches are used to help the area heal, and tenderness is felt for a short period of time.
The Program will facilitate evaluation by pulmonary, cardiology, dermatology, ophthalmology, rheumatology, and neurology sub-specialists, all of whom are specially trained in the treatment of sarcoidosis.