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Question : I have been diagnosed with sarcoidosis, but my doctor wants to be certain and has recommended a lung biopsy. How dangerous is this test? Also, what is the least invasive test?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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February 03, 2011
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A:

Sarcoidosis is an illness that causes tiny islands of inflammatory cells to form throughout the body. These microscopic groups of cells are called granulomas. They are especially common in the lungs, lymph nodes, skin, eyes and liver.

We don't know what causes sarcoidosis. But we do know what it looks like under the microscope. That's why a biopsy is usually needed to confirm the diagnosis.

I suspect your doctor already has examined you to see if there are any easier places to biopsy than the lung. Examples include:

  • A new brown bump on your skin
  • An enlarged lymph node
  • A tiny bump on the inside surface of your eyelid

However, a lung biopsy is often required.

A lung biopsy might sound scary but it is actually relatively safe when performed by a doctor with training and experience. The type of lung biopsy done most often to diagnose sarcoidosis is called bronchoscopy with a trans bronchial biopsy. The bronchoscope is a flexible tube with a light and small camera on the tip of the instrument.

During bronchoscopy, the tube is inserted through the mouth or nose. The doctor slowly passes the bronchoscope down into the trachea (windpipe) and bronchi (large air tubes leading from the trachea to the lungs). To limit discomfort, you will likely receive a light sedative. Your mouth or nose is numbed with a local anesthetic beforehand.

The doctor watches on a screen as the camera advances into one of the bronchi. A wire with a pincher on the end is passed through the bronchoscope. The doctor opens and closes the pincher to take a sample of lung tissue. This is usually repeated to get a few different samples. The procedure takes about 45 minutes. The samples are sent to the laboratory to be examined under the microscope.

As you should with any invasive test, ask the doctor to explain the possible complications before you sign the consent form.

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lung,biopsy,bronchi,bronchoscopy,microscope,nose,trachea
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