Affiliations 

  • 1 Department of Otorhinolaryngology-Head and Neck Surgery, University of Malaya, 50603, Kuala Lumpur, Malaysia. limbie89@gmail.com
  • 2 Department of Otorhinolaryngology-Head and Neck Surgery, University of Malaya, 50603, Kuala Lumpur, Malaysia
Eur Arch Otorhinolaryngol, 2023 Feb;280(2):925-927.
PMID: 36592173 DOI: 10.1007/s00405-022-07808-7

Abstract

BACKGROUND: Sarcoidosis is a granulomatous disorder involving multi-systemic organs. Patients invariably have lung involvement but some may have extrapulmonary disease. Rarely, cervical lymphadenopathy is the only sign without mediastinal or pulmonary abnormalities.

CASE PRESENTATION: We report a Malay male who complained of neck swelling exclusively. On imaging, multiple enlarged cervical lymph nodes deep to the sternocleidomastoid muscle were seen. An excision biopsy revealed non-caseating granulomas with epithelioid macrophages. Extensive investigations led to the diagnosis of isolated cervical lymph node sarcoidosis.

CONCLUSIONS: Sarcoidosis can present as cervical lymphadenopathy alone, without mediastinal or lung disease. The presence of epithelioid granulomas on histopathology warrants the exclusion of other granulomatous diseases. Isolated cervical lymph node sarcoidosis is only diagnosed in the presence of consistent clinical and radiological findings. In this case, close monitoring for systemic sarcoidosis is important as it can manifest later in life.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.