Unusual presentation of sarcoidosis

The extrapulmonary presentation of sarcoidosis is a frequent occurrence - over 30% of cases when the observation is prospective - but early diagnosis may still be a challenge. A comparison between two different Italian series - (1) patients visiting the Milan Sarcoidosis Clinic of an Internal Medicine Department and (2) an Italian Register from many pneumology centers (RIPID) - has shown a different approach to the diagnosis because pneumologists are more likely to use transbronchial biopsy, while internists are more likely to use extrapulmonary biopsies. Such a different clinical approach may be due in part to a different case mix of the two series.