Sarcoidosis is a rare multiorgan granulomatous disease of unknown etiology, 
mostly affecting young adults, with predilection for hilar lymph nodes and the 
lung. Despite clinical and histologic similarities between sarcoidosis and 
tuberculosis, the role of M. tuberculosis in the etiopathogenesis of sarcoidosis 
is still not clear. Over recent years numerous studies identifying peripheral 
blood T-cell response to various mycobacterial antigens were published. In 
parallel, there is no direct evidence for the role of alive M. tuberculosis in 
the development of sarcoidosis, as evidenced by negative culture in these 
patients. Exclusion of active tuberculosis as the granulomatous disease of known 
cause, still remain the important step in diagnostic work-up in sarcoidosis. 
Development of bronchoscopic techniques significantly reduced the number of 
surgical procedures. Combination of a few biopsy techniques: transbronchial 
needle aspiration, endobronchial biopsy and transbronchial lung biopsy, can 
achieve the optimum diagnostic yield. Because of the large percentage of 
spontaneous remission in sarcoidosis, the decision of treatment should be taken 
with caution. Corticosteroids still remain first-line therapy in sarcoidosis. 
Methotrexate is the most commonly used second-line drug. TNFα-antagonists are 
the therapeutic option in refractory sarcoidosis. In this article we summarise 
the present knowledge about the most common localization of sarcoidosis - 
pulmonary sarcoidosis, with special emphasis on the current etiologic 
hypothesis, possibility of diagnosis and treatment.