Sarcoidosis involving the thyroid and pleura

We report the coincidence of uncommon manifestations of sarcoidosis, each confirmed by percutaneous needle biopsy, revealing noncaseating granulomas. A patient presented with a thyroid nodule which demonstrated noncaseating granulomas on biopsy. When pleural effusion subsequently developed, pleural biopsy demonstrated noncaseating granulomas with no acid fast bacilli on stain or culture, and a diagnosis of sarcoidosis was made. Thyroid and pleural involvement are each rare manifestations of sarcoidosis, and are usually associated with extensive systemic disease. The diagnosis of sarcoidosis requires the appropriate clinical presentation, compatible histologic findings, and evaluation for other causes of granuloma formation.