Sarcoidosis
Sarcoidosis is a multisystem inflammatory disease characterised by non-necrotising granulomas, usually involving the lungs and intrathoracic lymph nodes; management balances spontaneous remission against progressive, organ-threatening or quality-of-life-limiting disease after infection and malignancy have been excluded.
Definition
Sarcoidosis is a multisystem inflammatory disease of unknown cause characterised by non-necrotising granulomas in affected organs, most commonly the lungs and intrathoracic lymph nodes, after appropriate exclusion of infection, malignancy and relevant exposure-related granulomatous disease.
First principles
A granuloma is a pattern, not a diagnosis
Sarcoidosis is an inflammatory granulomatous syndrome of unknown cause. Non-necrotising granulomas support the diagnosis only when the clinical and radiological pattern is compatible and important alternatives, particularly tuberculosis, fungal infection, berylliosis, silicosis and malignancy, have been considered. The diagnosis is therefore an integrated clinical, imaging, histological and microbiological decision rather than a label attached to a biopsy alone.
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