TY - JOUR T1 - Obstructive sinonasal granuloma: a rare complication of systemic sarcoidosis JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2022-253566 VL - 15 IS - 12 SP - e253566 AU - Amanda Walsh AU - Brandon Klein AU - Suzette Mikula Y1 - 2022/12/01 UR - http://casereports.bmj.com/content/15/12/e253566.abstract N2 - Sarcoidosis is a granulomatous disorder which presents with pulmonary involvement in >90% of cases. Sinonasal involvement is rare, occurring in 1% of all patients with sarcoidosis. It typically presents in the setting of active pulmonary disease. Here, we present a rare case of sinonasal sarcoidosis (SNS) in a patient with latent pulmonary sarcoidosis. The patient presented to our clinic with several years of nasal obstruction, rhinorrhea and cough unresponsive to medical management. Eventually, radiographic imaging was performed, revealing a large obstructive mass in the left nasal cavity. The mass was resected, and pathology demonstrated epithelioid granulomas, consistent with sarcoidosis. The patient was subsequently placed on systemic therapy with improvement in her symptoms. In summary, SNS is a rare clinical entity that infrequently presents in patients without active pulmonary involvement. Clinicians should have a low threshold to obtain imaging in patients with sarcoidosis who present with sinonasal complaints. ER -