What is Sarcoidosis? Symptoms and Diagnosis

Ingredients

What is Sarcoidosis Disease? Why Does It Happen?
Sarcoidosis Symptoms and Effects on the Body
Lung Involvement and Shortness of Breath
Skin, Eye and Other Organ Involvement
Stages of Sarcoidosis: How Does the Disease Progress?
Sarcoidosis Treatment Options
Medication: Cortisone and Other Immunomodulators
Follow-Up Process and Recovery Rates
The Role of Sarcoidosis and Thoracic Surgery
Frequently Asked Questions
Does Sarcoidosis Turn Into Cancer?
Does Sarcoidosis Disease Go Away Completely?
Is Sarcoidosis a Contagious Disease?
Scientific Bibliography

Sarcoidosis is a systemic disease that occurs as a result of the immune system overreacting to the body’s own tissues for an unknown reason.

The most basic feature of the disease is the appearance of small nodular structures formed by inflammatory cells, called “granulomas”, under the microscope.

Although these granulomas can occur in almost any organ of the body, the lungs and lymph nodes around the lungs are affected in more than 90% of cases.

Sarcoidosis usually occurs in young and middle-aged adults and often has the potential to heal spontaneously.

However, in some cases it can be progressive; Therefore, it is vital to make an accurate diagnosis and be followed up by a team of experts according to the stage of the disease.

What is Sarcoidosis Disease? Why Does It Happen?

Sarcoidosis is considered an uncontrolled response of the body’s defense mechanisms to certain substances in the air, infections or genetic factors.

While immune cells normally clump together to cleanse the body, in sarcoidosis, these cells form permanent clumps called granulomas instead of dispersing.

The exact cause of the disease is still being studied in the medical world; However, in individuals with a genetic predisposition, environmental triggers (dusts, chemicals, or certain microorganisms) are thought to initiate this process.

Sarcoidosis Symptoms and Effects on the Body

Sarcoidosis is a disease known as the “great mimic” because its symptoms can be confused with many different diseases.

Some patients may have no symptoms, while others may have sudden onset of severe symptoms.

Lung Involvement and Shortness of Breath

The epicenter of the disease is usually the lungs, and the most common symptoms are related to this area.

Dry Cough: Persistent and persistent coughing fits that are not accompanied by sputum.
Shortness of Breath: Shortness of breath, especially felt while exerting (walking, climbing stairs).
Chest Pain: Pressure or stinging sensation felt in the middle of the rib cage.

Skin, Eye and Other Organ Involvement

Sarcoidosis can affect not only the lungs but also many systems of the body at the same time.

Skin Symptoms: Painful, red bumps on the front of the legs (Erythema Nodosum) or skin rashes on the face.
Eye Involvement: Redness of the eye, sensitivity to light and blurred vision (Uveitis).
Lymph Nodes: Painless swelling in the neck, armpits, or groin areas.
General Symptoms: Extreme fatigue, night sweats, mild fever and joint pain.

Stages of Sarcoidosis: How Does the Disease Progress?

The course of sarcoidosis is divided into four main stages based on the findings on the chest X-ray.

This staging is used to determine the severity of the disease and how much treatment is needed.

Stage 1: There is only enlargement of the lymph nodes in the center of the lungs, the lung tissue is clean.
Stage 2: Both enlargement of the lymph nodes and granulomas in the lung tissue are seen.
Stage 3: Lymph nodes begin to shrink, but involvement in lung tissue continues.
Stage 4: Permanent damage (fibrosis/hardening) has occurred in the lungs.

Sarcoidosis Diagnosis and Diagnostic Methods

The diagnosis of sarcoidosis is made by eliminating diseases such as tuberculosis or lymphoma that have similar symptoms (exclusion diagnosis).

The diagnostic process is a combination of clinical examination, radiological imaging, and tissue diagnosis.

Chest X-ray and High-Resolution CT (HRCT)

Chest X-ray is the first screening method used to detect enlargement of lymph nodes.

However, HRCT (High Resolution Computed Tomography) provides much more detailed information to understand the extent of the disease and tissue damage.

The Necessity of EBUS and Biopsy for Definitive Diagnosis

Although imaging methods increase the suspicion of sarcoidosis, it is necessary to prove the presence of granulomas at the tissue level for a definitive diagnosis.

EBUS (Endobronchial Ultrasonography) is the most modern and comfortable method today that allows a piece to be taken from the trachea with a needle through the trachea without making a surgical incision.

Sampling with Mediastinoscopy Method

If sufficient samples cannot be taken with EBUS or the result remains suspicious, the “Mediastinoscopy” method is used.

This method allows larger pieces to be removed from the lymph nodes in the mediastinum through a small incision made in the lower neck, and the success rate of diagnosis is close to 100%.

Sarcoidosis Treatment Options

In a significant proportion of sarcoidosis patients (especially in Stage 1 cases), the disease may regress spontaneously without requiring any treatment.

Treatment decision; It is given according to whether organ functions are impaired and the patient’s quality of life.

Medication: Cortisone and Other Immunomodulators

The main goal of treatment is to suppress the overreaction in the immune system.

Corticosteroids (Cortisone) are the most effective drugs in reducing inflammation, but due to their side effects, they should be used under expert control, in gradual doses.

In patients who do not respond to cortisone or experience side effects, other (immunosuppressive) drugs that regulate the immune system can be switched.

Follow-Up Process and Recovery Rates

Sarcoidosis patients are usually followed up every 3 to 6 months.

While approximately 60-70% of patients recover completely with treatment or spontaneously, the disease may become chronic in a group of 10-20%.

Sarcoidosis Follow-up and Treatment Comparison Table

Feature	Observation (Follow-up) Process	Drug Treatment Process
Who is it applied to?	Stage 1 patients with no symptoms	Patients with reduced organ function
Purpose of Treatment	Waiting for spontaneous recovery	Preventing tissue damage and inflammation
Tools Used	Regular CT and Respiratory Tests	Cortisone and Immunosuppressives
Success Rate	High (Spontaneous remission)	High (Controlled recovery)

The Role of Sarcoidosis and Thoracic Surgery

The main role of thoracic surgery in sarcoidosis is “diagnostic” procedures.

Definite exclusion of serious diseases that mimic sarcoidosis, such as lymphoma and tuberculosis, is possible with sampling by the surgeon.

In addition, in rare cases, lung complications caused by sarcoidosis (air leaks, etc.) may require surgical intervention.

Prof. Dr. Levent Alpay: The biggest mistake in diagnosing sarcoidosis is to start treatment only by looking at tomography. The diagnosis must be confirmed with a tissue sample (biopsy). When we make the correct diagnosis with methods such as EBUS or Mediastinoscopy, we prevent the patient from using heavy drugs unnecessarily and ensure that they reach the right treatment as soon as possible.

Case Experience (Anonymous):

A 35-year-old patient who presented with the complaint of persistent cough and whose tomography revealed widespread lymph node enlargement underwent a biopsy with the EBUS method. The stage of the patient was determined after the pathology result was consistent with sarcoidosis. It was observed that the findings disappeared completely spontaneously at the 1st year follow-up of the patient, who was decided to follow up without medication due to its mild course.

If you have a suspected condition of sarcoidosis or require a professional evaluation for a definitive diagnosis, you can make an appointment with our clinic and seek expert opinion.

Frequently Asked Questions

Does Sarcoidosis Turn Into Cancer?

No, sarcoidosis is not a form of cancer and does not directly develop into cancer; However, regular follow-up of patients is recommended because it is an immune system disease.