sarcoidosis

My chest ct showed that my sarcoid (?) has intensified.  I have been on and off prednisone for three years.  I feel like it might not be sarcoid and it might be something else.  My problems have gotten worse.  Im  tired all the time and feel like ive got the flu.  I have tons of pain in my back and also have drenching night sweats.  All my breathing test come bact normal.  What should I do?  Should I ask the dr. to biopsy the tumors and just sit and wait.  

[National Jewish Health]

On initial presentation, sarcoidosis and a type of cancer called lymphoma may look the same, but the duration of your sarcoidosis rules out the diagnosis of lymphoma.  It can, however be confused with other immune diseases such as eosinophilic granuloma, berylliosis or even with what is called atypical mycobacterial disease, which is related to tuberculosis (TB) that is not contagious.  The drenching night sweats are worrisome for an infectious disease.

If you are truly getting sicker, as your message suggests, and especially if the clinical worsening is accompanied by x-ray or other objective changes, serious consideration should be given to a biopsy.  You and your doctors need to be certain about the diagnosis.

That your breathing tests remain normal is wonderful, given that one of the signs of progressive pulmonary sarcoidosis is a scarring of the lung, with a progressive decline in lung function.