A 27-year-old woman comes to the physician because of a 2-month history of increasing shortness of breath and a nonproductive cough. She has been unable to perform her daily activities. She has also had malaise and bilateral ankle pain during this period. Her temperature is 37.8°C (100.0°F), pulse is 100/min, respirations are 24/min, and blood pressure is 112/72 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 94%. Chest x-ray is shown below. A palpable lymph node in the supraclavicular bed is biopsied and pathology reveals well-formed, noncaseating granulomas. Which of the following is the most likely diagnosis?

Question

A 27-year-old woman comes to the physician because of a 2-month history of increasing shortness of breath and a nonproductive cough. She has been unable to perform her daily activities. She has also had malaise and bilateral ankle pain during this period. Her temperature is 37.8°C (100.0°F), pulse is 100/min, respirations are 24/min, and blood pressure is 112/72 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 94%. Chest x-ray is shown below.  A palpable lymph node in the supraclavicular bed is biopsied and pathology reveals well-formed, noncaseating granulomas.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Sarcoidosis is an inflammatory disorder characterized histologically by noncaseating granulomas consisting of aggregates of epithelioid macrophages and multinucleated giant cells.  Common manifestations include hilar adenopathy, pulmonary infiltrates, skin rash, ophthalmic findings, and constitutional symptoms.

A 27-Year-Old Woman Comes to the Physician Because of a 2-Month