[The first stage of sarcoidosis: the actual diagnostic possibilities (author's transl)]

A correct staging of sarcoidosis is of the uppermost importance in the diagnosis and treatment of the disease. In the last few years new concepts have been stated: --radiological staging of sarcoidosis is particularly difficult --in no one phase the radiological pattern can be considered typical but sometimes it is highly suggestive for sarcoidosis --anatomical studies recently showed that sarcoid disease seems to begin with a non granulomatous interstitial pneumonia. Following this individual microscopic deposit may conglomerate to form the typical non caseating granulomas. In the lung the disease seems to procede from the interstitium to the lymphnodes. Usually, in the first stage, possible sarcoidosis is diagnosed by the radiologist, but a confident diagnosis needs a pathological confirmation. Transbronchial biopsy guided by fluoroscopy is the first diagnostic choice for obtaining confirmation of the disease and for determining the type and entity of parenchymal lesions.