Hi doctor, on 25 dec my wife complained of pain in her right shoulder, after taking a few pain killers from local doctor we consulted a ortho and he also gave a 2 week course of pain killer but as the pain did not subside he asked for a chest xray which was done on 23 feb 19 which revealed bilateral hilar prominent ?vascular then on admission in the hospital a mri showed multiple enlarged mediastinal and biletaralhilar lymph nodes" report attached" further hrct with contrast showed mediastinal and biletaralhilar matted necrotic lymphadenopathy etc. Suggestive of kochs. Later did pet scan and reports were the same as hrct reports also did a ct guided biopsy ,all well but diagnosis remained inconclusive for lack of enough sample "reports attached" did multiple blood test (all reports attached) doctors suspected sarcoidosis and discharged without and any treatment saying it will take time and the body will cure itself. On consulting a well known chest specialist on 18 march 2019 he came to a conclusion that tb medication should be started and also got the mantoux test done which showed 22. 5 cms positive result, he also on my request started steroid 60 mg per day (as my wife had terrible back pain radiating to the front and stomach for the whole month of feb to mid march which never subsided even one bit even with pain killers, he also tapered the steroids after a week slowly her symptoms (mainly pain in back and stomach )subsided and now by god's grace is almost 99% better except for the side effects of the akt medication. Exactly 2 months after starting akt medication we got a hrct scan done which reports are the same as the one done before treatment and mild increase in the glands size and no much increase in quantity and reports suggestive of sarcoidosis. My question is (1) why have the glands size not decreased (2) if it could be sarcoidosis how did she get relief with akt medication.(3) my doctor says we will wait till the end of akt treatment .is it ok. Will the glands increase more and cause damage.