Selection of Biopsy Procedures for Sarcoidosis Diagnosis

Abstract

A diagnosis of sarcoidosis should not be made on the basis of clinical and radiologic characteristics alone, since similar changes occur in patients with tuberculosis, histoplasmosis, and lymphoma. Until standardized and stable Kveim test materials are developed, the demonstration by biopsy of epithelioid granulomas must be regarded as essential to the diagnosis of sarcoidosis. Sarcoidosis is, as a rule, a widely disseminated disease, so that numerous biopsy sites and methods have been successfully em- ployed. One consequence is that confusion exists as to the best methods. An example is our repeated experience of referring patients for surgical biopsy of palpable lymph nodes, only to have scalene fat pads excised in the belief that this approach afforded the greatest likelihood of demonstrating sarcoid tissue. It appeared that an analysis of our experience with biopsy techniques in 329 patients with sarcoidosis would be of value. The diagnosis in each case was based