Caseating lymphadenopathy at imaging: When ethnicity is deceptive

Abstract

Background: Lymph node enlargement represents a clinical challenge in clinical practice and the underlying diagnosis representsthe cornerstone of adequate treatment.

Case report: A caseating-like mediastinal lymph node investigated using computer tomography (CT) was found in an adultmale patient coming from Pakistan, and a diagnosis of sarcoidosis was made only on a pathological specimen obtained bytransbronchial needle aspiration.

Conclusion: To the best of our knowledge, caseating lymph-nodes have been never reported in sarcoidosis. It is important tonote that only the presence of the typical aspect of sarcoidosis in the pathological specimen of an apparent caseating lymph nodeseen at imaging permits the real diagnosis of sarcoidosis especially in those patients in whom infectious disease is prevalent.