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AN UNUSUAL PRESENTATION OF CHOROIDAL SARCOIDOSIS AND ITS MULTIMODAL IMAGING
Sandeep Randhawa1, James M Jumper
1*Department of Ophthalmology, Kaiser Permanente, Roseville, California; and †West Coast Retina Medical Group, San Francisco, California.
Purpose:
The purpose of this study was to report a case of a Filipino woman with a history of breast cancer who presented with unilateral choroidal infiltration, which led to the diagnosis of sarcoidosis.
Methods:
Case report and literature review.
Results:
A 64-year-old Filipino woman with a history of breast cancer presented with unilateral choroidal nodules. Her blood tests were negative for common causes of choroidal infiltration (angiotensin-converting enzyme, lysozyme, Treponema pallidum particle agglutination), and Mantoux skin test and a chest x-ray were negative. Her diagnosis could only be made by biopsy of the two hypermetabolic paratracheal nodes seen on the positron emission tomography-computed tomography.
Conclusion:
Choroidal infiltration may be the presenting feature of sarcoidosis even in ethnicities known to have very low incidence of the disease. If the chest x-ray is negative and the clinical suspicion warrants it, a CT or positron emission tomography-computed tomography of the thorax may be helpful in identifying nonhilar mediastinal lymphadenopathy. As in our case, fine-needle aspiration biopsy of these nodes may lead to confirmation of the diagnosis.
