[Pulmonary sarcoidosis presenting as multiple scattered pulmonary nodules: about a case]

Sarcoidosis is a multisystem granulomatous disease that can affect all organs, thoracic involvement often predominates representing its most evocative manifestation. Atypical manifestations, such as the presence of multiple scattered pulmonary nodules may indicate malignancy. Our study reports the case of a 56-year-old patient investigated for asthenia associated with paresthesia of the lower limbs evolving since 6 months. Chest CT scan showed multiple scattered pulmonary nodules. Histological examination of specimens obtained by bronchial biopsy allowed to exclude neoplastic origin and confirmed the diagnosis of sarcoidosis. On the basis of normal pulmonary function tests and the absence of extrapulmonary visceral involvement, simple patient monitoring was recommended. Radiologically sarcoidosis can exceptionally present as multiple scattered pulmonary nodules. Histological evidence is necessary to exclude other etiologies including tumors. Corticosteroids are indicated only in the presence of severe respiratory functional impairment and/or associated visceral involvement.