Diagnostic usefulness of epipharyngeal examination in sarcoidosis: Report of two cases

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We report diagnostic usefulness of epipharyngeal examinations in sarcoidosis.Case 1: A 68-year-old woman had sarcoidosis-suspected diffuse lung abnormalities, uveitis and thrombocytopenia but declined to undergo transbronchial lung biopsy. Then, we referred her to an ear-nose-throat (ENT) specialist who incidentally discovered a mass in her upper respiratory tract. The biopsy specimen of the lesion contained non-caseating epithelioid cell granulomas. After she was treated by beclomethasone inhalation for 10 months for her asthmatic symptoms, the epipharyngeal mass showed marked shrinkage.Case 2: A 23-year-old man with BHL was referred to our hospital and underwent transbronchial biopsy resulting in negative findings. An ENT specialist found rough surface in part in his epipharyngeal mucosa, and a biopsy of the portion disclosed sarcoid granulomas. He was followed up without treatment and the surface looked almost normal 10 months later, .These two patients had no significant symptoms suggesting any topical involvements in the epipharynx. Epipharyngeal examination is not so invasive that this procedure should be made more positively to bring about diagnostic benefit for the patients of suspected sarcoidosis.
日本サルコイドーシス/肉芽腫性疾患学会の論文