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A 30-year-old man was seen in the ophthalmology department due to blurred vision. He was suspected of having either tuberculous uveitis or sarcoidosis. The patient was referred to our department for further testing. On chest CT, mild swelling of the mediastinal and bilateral hilar lymph nodes was noted. However, serum ACE activity and γ-globulin fraction levels were normal. The patient had a weak positive tuberculin skin test, and the QuantiFERON®TB-2G (QFT) results were positive. In the bronchoalveolar lavage fluid (BALF), lymphocyte count was 13.6% and the CD4/CD8 ratio was low (0.72). Real-time endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) showed a granulomatous lesion, but a definite diagnosis could not be made. The patient was diagnosed as having sarcoidosis based on pathological examination of hilar lymph nodes obtained by thoracoscopic biopsy. Since the patient had atypical clinical test findings, it was difficult to differentiate sarcoidosis from tuberculosis. Therefore, we present this sarcoidosis patient and discuss his test findings.
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