Diagnosis and Detection of Sarcoidosis

In patients for whom there is a high clinical suspicion for sarcoidosis (e.g., Löfgren’s syndrome, lupus pernio, or Heerfordt’s syndrome), the ATS suggests NOT sampling lymph nodes.
(C, VL)

For patients presenting with asymptomatic, bilateral hilar lymphadenopathy, the ATS makes no recommendations for or against obtaining a lymph node sample.
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For patients with suspected sarcoidosis and mediastinal and/or hilar lymphadenopathy for whom it has been determined that tissue sampling is necessary, the ATS suggests endobronchial ultrasound (EBUS)-guided lymph node sampling, rather than mediastinoscopy, as the initial mediastinal and/or hilar lymph node sampling procedure. (C, VL)