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This guideline reviews the clinical features and differential diagnosis of sarcoidosis and presents an updated evidence-based discussion of testing for diagnosis and initial evaluation of patients with sarcoidosis.
For patients with asymptomatic bilateral hilar adenopathy, either lymph node biopsy or close follow-up (without biopsy) are acceptable; when hilar adenopathy is noted in patients with certain sarcoidosis presentations (e.g., Löfgren syndrome, Heerfordt syndrome, or lupus pernio), lymph node biopsy is not required.
When hilar or mediastinal lymph node biopsy is deemed to be necessary, endobronchial ultrasound-guided biopsy is recommended (rather than mediastinosco…