108. What is a lung biopsy?
This procedure consists of removing a tiny piece of the lung tissue
in order to examine it under the microscope. This is the single
most important test in correctly diagnosing your lung disease.
109. How often a sarcoidosis patient should
have a T8 test and a Gallium Scan?
Gallium is performed to study the extent and activity of sarcoidosis.
It may be used to assess the response of the disease to treatment.
A tuberculin (T81 test is performed initially when the sarcoidosis
patient is investigated in order to exclude tuberculosis.
110. I have never had a gallium scan should
No, not if you do not have any symptoms and your physician does
not feel a need for the test.
111. When is a mediastinoscopy indicated?
If a patient has enlarged glands in the mediastinum and the chest,
and the diagnosis has not been established by transbronchial lung
biopsy, then a mediastinoscopy is indicated.
112. What tests are there for predicting
disease activity in sarcoidosis?
Chest x-ray film, lung function tests, serum angiotensin converting
enzyme, serum calcium and Gallium-67 scan and lymphocytes in bronchoalveolar
lavage are some of the tests used to assess activity.
113. How useful is the serum angiotensin
converting enzyme (SACE) test?
Serum ACE level is high in about 60% of the patients with active
sarcoidosis. ACE level comes down when the disease undergoes remission
or responds to treatment. There are other conditions that also may
have high ACE levels including milary tuberculosis, leprosy, coccidioidomycosis
and lymphoma. Some patients with chronic fatigue syndrome (CFS)
may also have high serum ACE levels.
114. What is the single most specific test
to diagnose sarcoidosis?
The best way to diagnose sarcoidosis is to obtain a tissue biopsy
and demonstrate the presence of noncaseating granulomas, excluding
any other causes of the granulomatous reaction including tuberculosis,
histoplasmosis, coccidioidomycosis, and berylliosis.
115. If a person does not have sarcoidosis
and is injected with the Kveim antigen, is there any concern that
this person could later develop sarcoidosis?
116. Is Kveim-Siltzbach test FDA approved?
In this day and age of AIDS is the test safe?
Kveim-Siltzbach is not approved by the FDA. The test is safe; however,
the antigen is not available.