General Clinical Manifestations
Intrathoracic manifestations of sarcoidosis include pulmonary
infiltrates and hilar lymphadenopathy, as well as cardiac sarcoidosis
(more common in older Japanese females), which can be life-threatening
(1, 7). Extrathoracic disease occurs in around 50% of patients, and
virtually every organ can be affected (1). The extent and degree of
disease is extremely variable between patients. Skin, lymph node, eye
and liver involvement are most common outside of the thorax, each being
found in between 10-25% of patients (1).
Around 10-15% of patients with sarcoid have ENT manifestations of
sarcoidosis (1, 5, 9) which may be the presenting symptom of their
disease (10). The differential often includes vasculitides such as
granulomatosis with polyangiitis, formerly called Wegener’s, or
eosinophilic granulomatosis with polyangiitis, formerly Churg-Strauss
syndrome, granulomas of infective origin (such as tuberculosis,
aspergillosis, or actinomycosis), and inflammatory diseases with
extrasystemic manifestations, such as Crohn’s disease, which should be
excluded (4). Sinonasal sarcoidosis is rare (occurring in 1-4% of
patients), but has been described in numerous case studies, and is a
well-recognised chronic and stubborn form of the disease (8, 10, 11).
Sarcoidosis can also involve the larynx, salivary glands and ear in rare
cases (3, 12-16).