Rheumatology

Question 1

Young adult with 3 months of exertional dyspnea and cough with hyper calcemia and bilateral hilar LAD? How to diagnose? How to treat it?

Answer 1

Pulmonary Sarcoidosis
biopsy of hilar LAD
Steroid; most resolve (75%) over time

Question 2

Where to biopsy in sarcoidosis? hilar lymph node or peripheral skin lymph node

Answer 2

skin lymph node via excisional LN biopsy

if no easy access, then can do bronchoscopic lung biopsy at hilar LN