The Role of Ultrasonography in the Diagnosis of Systemic Sarcoidosis: a Case Report and Literature Review

Sarcoidosis is a granulomatous disease of unknown etiology that can involve various organs and tissues. The clinical manifestations vary greatly, so it is difficult to make a clear diagnosis of sarcoidosis with just the clinical manifestation and imaging findings. The diagnosis and treatment of a patient with systemic sarcoidosis was reported: a 51-year-old woman presented with a dry cough. Computed tomography (CT), magnetic resonance imaging (MRI), and conventional ultrasonography (US) suggested miliary nodules and inflammatory changes in the lungs, there was mediastinal, retroperitoneal and hilar lymph node enlargement and uneven liver echo, respectively. Positron emission tomography/computed tomography (PET-CT) further suggested that the lesions were distributed throughout the body, including the lymph nodes and muscles of the extremities; thus, systemic lymphoma was considered. Finally, ultrasound-guided biopsy of different sites yielded the same histopathological findings: sarcoidosis. The sarcoidosis in this case is characterized by a large number of involved sites with a wide range, and a variety of imaging data were complete but failed to suggest a diagnosis. Finally, a clear histopathological result was obtained under the guidance of ultrasound. This article reviewed the relevant literature and concluded that ultrasound-guided puncture to obtain histopathological results is a simple and effective method for the diagnosis of sarcoidosis.