SARCOIDOSIS MYTHOLOGY

Background. Sarcoidosis continues to be shrouded by anecdotal misinfor mation which has gained credence by repetition. These myths have been developing for the past 50 years and continue to accumulate, despite r emedial data;Among the most egregious myths are that sarcoidosis is a disease of Blacks, that the chest radiograph is diagnostic of sarcoido sis, and has chronologic significance, that serum angiotensin-converti ng enzyme and bronchoalveolar lavage are diagnostic of sarcoidosis and serve as guides to therapy, that the Kveim-Siltzbach test is not a re liable diagnostic test for sarcoidosis, that-sarcoidosis is difficult to diagnose, and that sarcoidosis is tuberculosis. Methods and Results . The literature regarding these myths has been reviewed and supported by the experience with more than 10,000 patients with sarcoidosis who have been treated at Mount Sinai Medical Center, New York. Conclusion s. Sarcoidosis occurs with varying frequency among all races. The ches t radiograph typical of sarcoidosis can be mimicked by other granuloma tous and neoplastic diseases. The classic radiographic stages, from 0 to III, do not reflect the time course of sarcoidosis. The Kveim-Siltz bach test is an excellent diagnostic procedure. The diagnosis of sarco idosis can be made relatively easily in most patients, but its etiolog y is still unknown.