Sarcoidosis as an Uncommon Cause of Chest Pain: A Case Report

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Despite primarily affecting the lung, sarcoidosis can affect any organ, resulting in various clinical manifestations. We present a case of a 56-year-old man who developed thoracic pain over several months along with skin lesions. The chest CT revealed multiple mediastinal lymphadenopathies. The patient underwent an endobronchial ultrasound, and a lymph node biopsy was performed. The histological results showed lymphoid cells and small epithelioid granulomas, while bronchoalveolar lavage revealed lymphocytosis, with a significantly elevated CD4+/CD8+ ratio. Based on the results, a diagnosis of sarcoidosis was presumed. The study was concluded with cardiac MRI due to complaints of chest pain, which also confirmed cardiac involvement. The patient was successfully treated with corticosteroids, exhibiting significant improvements and recovering completely during the follow-up period. Despite cardiac involvement in sarcoidosis being rare, we present this case to emphasize the challenges in diagnosis, requiring high clinical suspicion and the use of complementary imaging methods, such as cardiac magnetic resonance. We also emphasize the importance of early initiation of corticosteroid therapy to prevent major complications and promote recovery.