{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:41:46Z","timestamp":1785897706003,"version":"3.56.0"},"reference-count":51,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Current Opinion in Immunology"],"published-print":{"date-parts":[[2025,12]]},"DOI":"10.1016\/j.coi.2025.102652","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T23:42:16Z","timestamp":1756770136000},"page":"102652","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"special_numbering":"C","title":["Challenges in diagnosis of sarcoidosis"],"prefix":"10.1016","volume":"97","author":[{"given":"Karol","family":"B\u0105czek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech J","family":"Piotrowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7579-9767","authenticated-orcid":false,"given":"Francesco","family":"Bonella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.coi.2025.102652_bib1","doi-asserted-by":"crossref","DOI":"10.1088\/1752-7163\/ab1284","article-title":"The role of measuring exhaled breath biomarkers in sarcoidosis: a systematic review","volume":"13","author":"Terrington","year":"2019","journal-title":"J Breath Res"},{"key":"10.1016\/j.coi.2025.102652_bib2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1067\/j.cpradiol.2020.10.013","article-title":"Sarcoidosis, the master mimicker","volume":"51","author":"Jameson","year":"2022","journal-title":"Curr Probl Diagn Radio"},{"key":"10.1016\/j.coi.2025.102652_bib3","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/MCP.0000000000000715","article-title":"Sarcoidosis epidemiology: recent estimates of incidence, prevalence and risk factors","volume":"26","author":"Arkema","year":"2020","journal-title":"Curr Opin Pulm Med"},{"key":"10.1016\/j.coi.2025.102652_bib4","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1055\/s-0040-1713008","article-title":"Overlap syndromes in sarcoidosis: clinical features and outcomes","volume":"41","author":"James","year":"2020","journal-title":"Semin Respir Crit Care Med"},{"key":"10.1016\/j.coi.2025.102652_bib5","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.chest.2018.03.056","article-title":"Drug-induced sarcoidosis-like reactions","volume":"154","author":"Chopra","year":"2018","journal-title":"Chest"},{"key":"10.1016\/j.coi.2025.102652_bib6","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1080\/17476348.2020.1794827","article-title":"Granulomatous lung disease: clinical aspects","volume":"14","author":"Chopra","year":"2020","journal-title":"Expert Rev Respir Med"},{"key":"10.1016\/j.coi.2025.102652_bib7","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2021.680989","article-title":"Granulomatous sarcoidosis mimics","volume":"8","author":"Judson","year":"2021","journal-title":"Front Med"},{"key":"10.1016\/j.coi.2025.102652_bib8","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaut.2024.103288","article-title":"A framework for exclusion of alternative diagnoses in sarcoidosis","volume":"149","author":"Harper","year":"2024","journal-title":"J Autoimmun"},{"key":"10.1016\/j.coi.2025.102652_bib9","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1164\/rccm.202002-0251ST","article-title":"Diagnosis and detection of sarcoidosis: an ATS clinical practice guideline","volume":"201","author":"Crouser","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.coi.2025.102652_bib10","doi-asserted-by":"crossref","DOI":"10.1183\/16000617.0012-2017","article-title":"Differential diagnosis of granulomatous lung disease: clues and pitfalls","volume":"26","author":"Ohshimo","year":"2017","journal-title":"Eur Respir Rev"},{"key":"10.1016\/j.coi.2025.102652_sbref11","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.pulmoe.2023.11.008","article-title":"EBUS-guided cryobiopsy in the diagnosis of thoracic disorders","volume":"30","author":"Poletti","year":"2024","journal-title":"Pulmonology"},{"key":"10.1016\/j.coi.2025.102652_bib12","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/MCP.0000000000000500","article-title":"Sarcoidosis and autoimmune diseases: differences, similarities and overlaps","volume":"24","author":"Korsten","year":"2018","journal-title":"Curr Opin Pulm Med"},{"key":"10.1016\/j.coi.2025.102652_bib13","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.humpath.2022.12.014","article-title":"Classic Hodgkin lymphoma with marked granulomatous reaction: clinicopathologic study of 20 cases","volume":"134","author":"Xu","year":"2023","journal-title":"Hum Pathol"},{"key":"10.1016\/j.coi.2025.102652_bib14","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000000121","article-title":"Sarcoidosis occurring after lymphoma: 14-patient report and literature review","volume":"93","author":"London","year":"2014","journal-title":"Medicine"},{"key":"10.1016\/j.coi.2025.102652_bib15","doi-asserted-by":"crossref","first-page":"233","DOI":"10.5858\/arpa.2020-0543-RA","article-title":"Pathology of granulomatous pulmonary diseases","volume":"146","author":"Rosen","year":"2022","journal-title":"Arch Pathol Lab Med"},{"key":"10.1016\/j.coi.2025.102652_bib16","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1136\/thoraxjnl-2011-200063","article-title":"Utility of EBUS-TBNA in tuberculous intrathoracic lymphadenopathy: a multicentre study","volume":"66","author":"Navani","year":"2011","journal-title":"Thorax"},{"key":"10.1016\/j.coi.2025.102652_bib17","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/resp.12449","article-title":"EBUS-TBNA for diagnosis of sarcoidosis in unselected populations","volume":"20","author":"Trisolini","year":"2015","journal-title":"Respirology"},{"key":"10.1016\/j.coi.2025.102652_bib18","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/LBR.0b013e318233016c","article-title":"Randomised study of 21- vs 22-gauge EBUS-TBNA needles for histology","volume":"18","author":"Oki","year":"2011","journal-title":"J Bronchol Inter Pulmonol"},{"key":"10.1016\/j.coi.2025.102652_sbref19","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.pccm.2024.05.002","article-title":"Evolution of transbronchial needle aspiration needles over the last half-century","volume":"2","author":"Zhu","year":"2024","journal-title":"Chin Med J Pulm Crit Care Med"},{"key":"10.1016\/j.coi.2025.102652_bib20","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5603\/ARM.2017.0012","article-title":"Initial polish experience of flexible 19-gauge EBUS-TBNA","volume":"85","author":"Gnass","year":"2017","journal-title":"Adv Respir Med"},{"key":"10.1016\/j.coi.2025.102652_bib21","doi-asserted-by":"crossref","first-page":"321","DOI":"10.20452\/pamw.2828","article-title":"Conventional vs ultrasound-guided needle biopsy in sarcoidosis: randomised trial","volume":"125","author":"Gnass","year":"2015","journal-title":"Pol Arch Med Wewn"},{"key":"10.1016\/j.coi.2025.102652_bib22","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/resp.14182","article-title":"EBUS vs EUS-B for diagnosing sarcoidosis: ISA RCT","volume":"27","author":"Crombag","year":"2022","journal-title":"Respirology"},{"key":"10.1016\/j.coi.2025.102652_sbref23","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2024-002617","article-title":"Ultrasound-guided transbronchial cryobiopsy of mediastinal and hilar lesions: a multicentre pragmatic cohort study with real-world evidence","volume":"11","author":"Mangold","year":"2024","journal-title":"BMJ Open Respir Res"},{"key":"10.1016\/j.coi.2025.102652_bib24","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-019-0780-3","article-title":"Diagnostic yield and risk\/benefit of trans-bronchial lung cryobiopsy in diffuse parenchymal lung diseases: 699 patients","volume":"19","author":"Ravaglia","year":"2019","journal-title":"BMC Pulm Med"},{"key":"10.1016\/j.coi.2025.102652_bib25","article-title":"Cryobiopsy vs forceps biopsy in sarcoidosis: a randomised multicentre trial","volume":"10","author":"H\u00e4ntschel","year":"2021","journal-title":"J Clin Med"},{"key":"10.1016\/j.coi.2025.102652_sbref26","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines11010175","article-title":"The risk of sarcoidosis misdiagnosis and the harmful effect of corticosteroids when the disease picture is incomplete","volume":"11","author":"Arcana","year":"2023","journal-title":"Biomedicines"},{"key":"10.1016\/j.coi.2025.102652_sbref27","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S2213-2600(23)00267-9","article-title":"Sarcoid Delphi Group. High-resolution CT phenotypes in pulmonary sarcoidosis: a multinational Delphi consensus study","volume":"12","author":"Desai","year":"2024","journal-title":"Lancet Respir Med"},{"key":"10.1016\/j.coi.2025.102652_bib28","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/17476348.2020.1682997","article-title":"18F-FDG PET\/CT in pulmonary sarcoidosis: quantifying inflammation by the TLG index","volume":"14","author":"Papiris","year":"2020","journal-title":"Expert Rev Respir Med"},{"key":"10.1016\/j.coi.2025.102652_bib29","first-page":"44","article-title":"Volumetric FDG PET analysis of global lung inflammation: new tool for precision medicine in pulmonary sarcoidosis?","volume":"35","author":"Adams","year":"2018","journal-title":"Sarcoidosis Vasc Diffus Lung Dis"},{"key":"10.1016\/j.coi.2025.102652_sbref30","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13226974","article-title":"Chronic sarcoidosis: diagnostic difficulties and search for new criteria of inflammatory activity (case report & review)","volume":"13","author":"Starshinova","year":"2024","journal-title":"J Clin Med"},{"key":"10.1016\/j.coi.2025.102652_sbref31","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.1007\/s00330-024-10949-4","article-title":"Meta-analysis of 18F-FDG PET\/CT in pulmonary sarcoidosis","volume":"35","author":"Donnelly","year":"2025","journal-title":"Eur Radio"},{"key":"10.1016\/j.coi.2025.102652_bib32","doi-asserted-by":"crossref","DOI":"10.1186\/s13550-019-0505-x","article-title":"Quantification of pulmonary disease activity in sarcoidosis measured with 18F-FDG PET\/CT: SUVmax versus total lung glycolysis","volume":"9","author":"Schimmelpennink","year":"2019","journal-title":"EJNMMI Res"},{"key":"10.1016\/j.coi.2025.102652_bib33","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1007\/s12149-016-1095-6","article-title":"The utility of PET\/CT with 68Ga-DOTATOC in sarcoidosis: comparison with 67Ga-scintigraphy","volume":"30","author":"Nobashi","year":"2016","journal-title":"Ann Nucl Med"},{"key":"10.1016\/j.coi.2025.102652_sbref34","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.027971","article-title":"Pathophysiological gaps, diagnostic challenges, and uncertainties in cardiac sarcoidosis","volume":"12","author":"Ueberham","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.coi.2025.102652_bib35","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1055\/s-2007-991521","article-title":"Bronchoalveolar lavage in sarcoidosis","volume":"28","author":"Drent","year":"2007","journal-title":"Semin Respir Crit Care Med"},{"key":"10.1016\/j.coi.2025.102652_bib36","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaut.2024.103247","article-title":"The immunopathogenesis of sarcoidosis","volume":"149","author":"Miedema","year":"2024","journal-title":"J Autoimmun"},{"key":"10.1016\/j.coi.2025.102652_bib37","doi-asserted-by":"crossref","DOI":"10.1186\/1465-9921-11-25","article-title":"Different HLA-DRB1 allele distributions in distinct clinical subgroups of sarcoidosis patients","volume":"11","author":"Grunewald","year":"2010","journal-title":"Respir Res"},{"key":"10.1016\/j.coi.2025.102652_bib38","first-page":"1380","article-title":"High-density genetic mapping identifies new susceptibility variants for sarcoidosis phenotypes and shows ethnic differences","volume":"48","author":"Rivera","year":"2016","journal-title":"Eur Respir J"},{"key":"10.1016\/j.coi.2025.102652_bib39","doi-asserted-by":"crossref","DOI":"10.1186\/s12931-024-02833-y","article-title":"Increased proportions of circulating PD-1+ CD4+memory T cells and PD-1+ regulatory T cells associate with good response to prednisone in pulmonary sarcoidosis","volume":"25","author":"Miedema","year":"2024","journal-title":"Respir Res"},{"key":"10.1016\/j.coi.2025.102652_bib40","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaut.2023.103120","article-title":"Circulating T cells in sarcoidosis have an aberrantly activated phenotype that correlates with disease outcome","volume":"149","author":"Miedema","year":"2024","journal-title":"J Autoimmun"},{"key":"10.1016\/j.coi.2025.102652_bib41","doi-asserted-by":"crossref","DOI":"10.3390\/biom8030084","article-title":"YKL-40, soluble IL-2 receptor, angiotensin-converting enzyme and C-reactive protein: comparison of markers of sarcoidosis activity","volume":"8","author":"Uysal","year":"2018","journal-title":"Biomolecules"},{"key":"10.1016\/j.coi.2025.102652_bib42","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s00408-015-9826-3","article-title":"Diagnostic utility of angiotensin-converting enzyme in sarcoidosis: a population-based study","volume":"194","author":"Ungprasert","year":"2016","journal-title":"Lung"},{"key":"10.1016\/j.coi.2025.102652_bib43","doi-asserted-by":"crossref","DOI":"10.3390\/biom12101400","article-title":"Performance of serum angiotensin-converting enzyme in diagnosing sarcoidosis and predicting activity: a meta-analysis","volume":"12","author":"Hu","year":"2022","journal-title":"Biomolecules"},{"key":"10.1016\/j.coi.2025.102652_bib44","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s10875-012-9754-4","article-title":"Human chitotriosidase: a sensitive biomarker of sarcoidosis","volume":"33","author":"Bargagli","year":"2013","journal-title":"J Clin Immunol"},{"key":"10.1016\/j.coi.2025.102652_bib45","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1164\/rccm.201507-1499OC","article-title":"Interferon-\u03b3\u2013producing Th17.1 cells are increased in sarcoidosis and are more prevalent than Th1 cells","volume":"193","author":"Ramstein","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.coi.2025.102652_bib46","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9082363","article-title":"Clinical presentations, pathogenesis and therapy of sarcoidosis: state of the art","volume":"9","author":"Polverino","year":"2020","journal-title":"J Clin Med"},{"key":"10.1016\/j.coi.2025.102652_bib47","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000007595","article-title":"Multidisciplinary approach and long-term follow-up in sarcoidosis: a 40-year cohort","volume":"96","author":"Ma\u00f1\u00e1","year":"2017","journal-title":"Medicine"},{"key":"10.1016\/j.coi.2025.102652_sbref48","doi-asserted-by":"crossref","DOI":"10.1186\/s13023-024-03152-7","article-title":"Diagnostic delay of sarcoidosis: an integrated systematic review","volume":"19","author":"Namsrai","year":"2024","journal-title":"Orphanet J Rare Dis"},{"key":"10.1016\/j.coi.2025.102652_bib49","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.compbiomed.2018.11.008","article-title":"Cardiac sarcoidosis classification with deep neural-network features using polar maps","volume":"104","author":"Togo","year":"2019","journal-title":"Comput Biol Med"},{"key":"10.1016\/j.coi.2025.102652_bib50","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.2967\/jnumed.121.263598","article-title":"Distinction of lymphoma from sarcoidosis on 18F-FDG PET\/CT: radiomics-guided machine learning vs human readers","volume":"63","author":"Lovinfosse","year":"2022","journal-title":"J Nucl Med"},{"key":"10.1016\/j.coi.2025.102652_bib51","first-page":"00489","article-title":"Proteomic profiling of ILDs: an explorative study","volume":"7","author":"Majewski","year":"2021","journal-title":"ERJ Open Res"}],"container-title":["Current Opinion in Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0952791525001281?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0952791525001281?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:37:31Z","timestamp":1775032651000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0952791525001281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":51,"alternative-id":["S0952791525001281"],"URL":"https:\/\/doi.org\/10.1016\/j.coi.2025.102652","relation":{},"ISSN":["0952-7915"],"issn-type":[{"value":"0952-7915","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Challenges in diagnosis of sarcoidosis","name":"articletitle","label":"Article Title"},{"value":"Current Opinion in Immunology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.coi.2025.102652","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"102652"}}