Systemic sarcoidosis in a TB-endemic region: diagnostic role of linear endobronchial ultrasound mediastinal lymph node cryobiopsy and stepwise management approach.

Systemic sarcoidosis in a TB-endemic region: diagnostic role of linear endobronchial ultrasound mediastinal lymph node cryobiopsy and stepwise management approach.

Publication date: Jan 29, 2026

Sarcoidosis is a multisystem granulomatous disease that can mimic tuberculosis (TB) or lymphoma, particularly in endemic regions. We report a man in his late 50s with chronic cough, weight loss and systemic features whose CT showed mediastinal and abdominal lymphadenopathy with splenic lesions. Histology from endobronchial ultrasound-guided transbronchial cryobiopsy revealed non-caseating granulomas, confirming sarcoidosis and excluding TB and malignancy. He responded well to corticosteroids with methotrexate as a steroid-sparing agent. This case emphasises the diagnostic challenge of sarcoidosis in TB-endemic regions and highlights the added value of cryobiopsy in obtaining adequate tissue for diagnosis.

Concepts Keywords
50s Diagnosis, Differential
Linear Humans
Lymphadenopathy Interstitial lung disease
Methotrexate Lung function
Ultrasound Lymph Nodes
Lymphadenopathy
Male
Mediastinum
Methotrexate
Methotrexate
Middle Aged
Sarcoidosis
Tomography, X-Ray Computed
Tuberculosis

Semantics

Type Source Name
disease MESH sarcoidosis
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH lymphoma
disease MESH chronic cough
disease MESH weight loss
disease MESH lymphadenopathy
disease MESH granulomas
disease MESH malignancy
drug DRUGBANK Methotrexate
disease MESH Interstitial lung disease

Original Article

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