Rare Presentations of Sarcoidosis: Cases of Non-Pulmonary Involvement

Sarcoidosis, an inflammatory disease characterized by non-caseating granulomas of unknown etiology, typically manifests with pulmonary involvement. However, presentations without pulmonary manifestations are exceedingly rare. We present 2 cases illustrating unusual presentations of sarcoidosis without pulmonary involvement. A 60-year-old male presented with chronic joint pain and swelling in the left hand. Despite recurrent hospital visits and inconclusive evaluations, granulomatous tenosynovitis was confirmed through histopathological examination. Systemic involvement was ruled out, and the patient responded well to corticosteroid therapy. A 36-year-old female exhibited persistent subcutaneous nodules on the left hand for 6 years. A biopsy confirmed non-caseating granulomas consistent with sarcoidosis. Despite the absence of pulmonary findings, systemic screening revealed no further involvement. Intralesional corticosteroid therapy yielded significant improvement. Although sarcoidosis typically presents with pulmonary involvement, cases without pulmonary manifestations are rare. Our cases highlight the diagnostic challenges and delayed recognition of such presentations. Increased awareness of atypical presentations is crucial for timely diagnosis and management to prevent potential systemic complications.