title: The challenges of extrapulmonary presentations of sarcoidosis: A case report and review of diagnostic strategies.
abstract: A patient presenting with overweight, amenorrhea, diabetes insipidus, and oral, nasal, and pharyngeal inflammation was admitted to our hospital. Using a non-invasive approach, we were able to narrow the differential diagnosis down to a systemic lymphoproliferative or granulomatous disease, most likely sarcoidosis. This diagnosis was eventually confirmed by a biopsy of an enlarged tonsil. To our knowledge, tonsil biopsies have not been reported to be of help in the diagnostic strategy for systemic sarcoidosis. In this report, we review the possible diagnostic approaches and point out that the pharyngeal tonsils, if enlarged or inflamed, can be targeted to obtain tissue for histological confirmation.
authors.affiliation: Department of General Internal Medicine, Leiden University Medical Center, Building 1, C1-R45, PO Box 9600, 2300RC Leiden, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Bauer
authors.forename: P A
authors.initials: PA
authors.lastname: Brouwer
authors.forename: V T H B M
authors.initials: VT
authors.lastname: Smit
authors.forename: J T
authors.initials: JT
authors.lastname: Tamsma