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Case Reports
. 2022;39(1):e2022010.
doi: 10.36141/svdld.v39i1.11084. Epub 2022 Mar 31.

Nasopharyngeal sarcoidosis: case reports and literature review

Giacomo Benettini  1 , Luca Bruschini  1 , Giacomo Fiacchini  1 , Matteo Vianini  1 , Silvia De Santi  1 , Lucrezia Sparacino  1 , Valentina Donati  2 , Stefano Berrettini  1 , Andrea De Vito  1
Affiliations
Case Reports

Nasopharyngeal sarcoidosis: case reports and literature review

Giacomo Benettini et al. Sarcoidosis Vasc Diffuse Lung Dis. 2022.

Abstract

Sarcoidosis is a multisystemic inflammatory chronic disease characterized by the presence of noncaseating granulomas most frequently in lungs and in intrathoracic lymph nodes. The nasopharyngeal form is unusual and noncommon in the ENT practice.

Background and objectives: In order to establish a correct knowledge about this rare disease, we report two different cases of nasopharyngeal sarcoidosis moreover all the available literature is reviewed.

Materials and methods: A systematic literature review was made through PubMed databases, according to the PRISMA guidelines (1), combining the following key words: Nasopharyngeal, Rhinopharynx, Sarcoidosis, in publications between 1951 and 2020. In addition, we reported our personal experience on the disease by describing two clinical cases that occurred at our clinic in November 2018 and June 2019.

Results: 16 articles reported 27 cases of nasopharyngeal sarcoidosis. The number of males was 13 (48,2%) and the number of females was 14 (51,8%) with a mean age at the diagnosis of 35,28 ± 13.05 years old (range 5 - 64). In 16 (59,3%) cases nasopharyngeal sarcoidosis was associated with lungs and/or intrathoracic lymph nodes involvement; nasal obstruction was the most frequently reported symptom (51,8% of subjects).

Conclusions: Nasopharyngeal sarcoidosis can mimic several disorders of the upper airway respiratory tract and it must therefore be considered in the differential diagnosis. A biopsy of nonspecific lesions in the nasopharynx is advisable to permit several early diagnosis of upper airway respiratory tract disorders including sarcoidosis.

Keywords: nasopharyngeal biopsy; nasopharyngeal sarcoidosis; sarcoidosis.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Lesions in the rhinopharynx in case 1 (A) and case 2 (B).
Figure 2.
Figure 2.
Nasopharyngeal tissue with numerous, diffuse non-caseating epithelioid granulomas, composed by epithelioid cells (A-D) with rare Langhans giant cells (highlighted by arrows in B) (H&E: A-B, x40; C, x100; D, x200).
Figure 3.
Figure 3.
PET-CT examination shows partially excavated micronodule with moderate metabolic hyperactivity (SUV 7,1 max) in the anterior segment of the left upper lobe (green arrow), concomitant with some slightly hypermetabolic lymph nodes in the bilateral and subcarinal hilar area. Presence of glucose hypermetabolism (SUV 8,7 max) in the nasopharyngeal region (white arrow).
Figure 4.
Figure 4.
PRISMA 2009 flow diagram: selection of cases.
See this image and copyright information in PMC

References

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