title: Sneaky Sarcoidosis or a Metastatic Masquerade? - A case of nodular sarcoidosis.
abstract: Sarcoidosis is a multisystem disease of unclear pathogenesis that peaks between ages 20 to 39. Sarcoidosis is more common in women and affects blacks three times more frequently than whites. Nodular sarcoidosis is a rare variant of sarcoid that occurs in 1-4 percent of patients. It presents in female smokers with cough and shortness of breath. Nodular sarcoidosis often also presents as multifocal bilateral ill-defined nodules mimicking airspace disease or malignancy on imaging. Patients generally have a favorable prognosis, with complete resolution of the masses with steroid treatment. Herein, we present a case of nodular sarcoidosis in a female smoker who presented with cough, weight loss, and fever. Imaging revealed multiple pulmonary nodules, a dominant lung mass, and lymphadenopathy suggestive of malignancy. Ultimately, the patient underwent bronchoscopy and was diagnosed with nodular sarcoidosis; there was no evidence of malignancy or infectious process. Resolution of her symptoms ensued with steroid treatment.
authors.affiliation: At the time of the case Dr. Oncale was affiliated with the Tulane University Hospitals and Clinics of Internal Medicine as internal medicine residents. Dr. Oncale is currently affiliated with the Ochsner Health System as an academic hospitalist.
authors.forename: Melody
authors.initials: M
authors.lastname: Oncale
authors.affiliation: At the time of the case Dr. Boswell was affiliated with the Tulane University Hospitals and Clinics of Internal Medicine as internal medicine residents.Dr. Boswell is now affiliated with the Tulane University Hospital and Clinics,Department of Infectious Diseases.
authors.forename: Erin
authors.initials: E
authors.lastname: Boswell
authors.affiliation: Dr. Hefler is currently affiliated with the Tulane University Hospitals and Clinics Department of Gastroenterology.
authors.forename: Henry
authors.initials: H
authors.lastname: Hefler
mesh_terms: D001999:Bronchoscopy; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008875:Middle Aged; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects*