Patient case (clinical description): A 39-year-old woman comes to the clinic complaining of arthralgias and nodules on her legs.  She has no fever or other skin rashes. The prior medical condition is unremarkable, and she takes no medications.  On physical examination, there is moderate hepatomegaly. The lesions on her legs are tender and present predominantly on the anterior surface of the lower extremities. She doesn't smoke and drinks alcohol occasionally. The patient has 2 male sexual partners. Vital signs are normal. Chest x-ray demonstrates enlarged hilar lymph nodes, and laboratory testing reveals an elevated ACE level. Biopsy of the skin lesion shows noncaseating granulomas that stain negative for fungi & acid-fast bacilli.

Patient's own account: I'm just a 39-year-old young woman but lately I have noticed some underlying cysts on my legs and my joints were hurting so much. I don't have a fever. I don't have rashes. My medical history is totally clean and I don't take any medication. When I went to the clinic they did a physical examination where they found that my liver is enlarged. They also found that the lesions on my legs are kind of tender and they are located on the front side of my legs. I do not smoke and I drink alcohol occasionally. I have to male sexual partners. On the day of my visit my vitals were fine. I did an X-ray of my chest and I had swollen lymph nodes. I also has a blood test and it came back with a high ACE level. I also had a biopsy of my skin lesions that came back negative for fungi and AFB.

Clinical trial: A Trial to Compare Two Methods of Obtaining Tissue for Diagnosis of Sarcoidosis Namely the Conventional Method or the Ultrasound Guided Method

Eligibility criteria:
Inclusion Criteria:

          -  Age > 18 years and suspected Stage 1 (mediastinal or hilar Lymphadenopathy (LAP)) or
             Stage 2 ( LAP and parenchymal abnormalities) sarcoidosis

          -  Significant mediastinal LAP (Short Axis Diameter more than 10mm)

          -  Lymph Node (LN) enlargement in station 4, 7, 10 or 11 and CT chest findings consistent
             with sarcoidosis.

          -  With or without supportive evidence of sarcoidosis - hypercalcemia, calciuria, raised
             ACE levels or restriction/obstruction on Pulmonary Function Tests (PFT).

        Exclusion Criteria:

          -  Obvious other organ involvement with possibility to confirm granuloma with minimally
             invasive diagnostic procedure (Skin biopsy, superficial lymph nodes, Lofgren's
             Syndrome)

          -  Sarcoidosis Stage 3 and 4

          -  Mediastinal Nodes less than 10 mm in short axis diameter

          -  Absence of right paratracheal and subcarinal Lymph node enlargement more than 1 cm in
             short axis diameter

          -  Those who received empiric Steroid for >2 weeks in preceding 3 months

          -  Contraindication to bronchoscopy and TBNA (Coagulopathy, Hypoxemia)

          -  Unwilling to give consent
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 90 Years

Eligibility (NLI label): Contradiction