Endobronchial sarcoid mass: Uncommon presentation of the disease

Abstract

Sarcoidosis is a multisystemic disorder, which mainly affects the respiratory system. Diagnosis is based on the exclusion of other infectious, interstitial and neoplastic diseases and a typical pathology. Presentation as an endobronchial mass is very rare. We describe a patient who presented with dry cough, mild fever, night sweats, asthenia and thoracic pain. Chest radiograph showed an increase of the right hilum. A Computed Tomography showed right parahiliar adenopathies with mediastinal involvement. Physical examination and routine serological and biochemistry tests were normal. Bronchoscopy showed a mass that occluded the entrance to the right segment IX. Its biopsy showed epitelial granulomatosis without necrosis. No malignancy was observed. The biological samples cultures were negative for mycobacterium. A diagnosis of sarcoidosis was made. The symptoms disappeared. No treatment was prescribed, remaining the patient asymptomatic. A tumoral behaviour of sarcoidosis is not usual, however, a mass presentation is very rare. Bronchial biopsy is mandatory for a confirmation diagnosis.