Paper Title
Pandora Box: A Case Report on Unusual Presentation of Sarcoid as Unilateral Pulmonary Granulomatous Mass

Background: Sarcoidosis is a chronic multisystem autoimmune disease that is characterized pathologically by non-caseating granulomas. It could present with a myriad of manifestations ranging from generalized constitutional manifestations of fever, malaise, and weight loss to organ-specific involvement; hence, has been described as a “great imitator” Case report: A 65yr old male patient came with complaints of breathlessness on exertion since last 3 month aggravated since 15days and chest and back pain since 7days. Chest pain not radiating in any direction, not aggravated by exertion, cough and/or heavy weight object lifting. No history of cough, fever, chest trauma. After the following brief history taking and examination probable diagnosis at this point was massive left sided pleural effusion. In USG, no evidence of pleural fluid in left thorax but a mass or questionableconsolidation in left hemithorax was found. In HRCT, Mediastinal dermoid of size 17*14*19cms in left hemithorax with fat and solid component within, resultant lung volume loss towards right side was reported in CT thorax. CT guided lung biopsyreport suggested of Granulomatous inflammation with non caeseating core probably questionable sarcoidosis. After which serum ACE levels were done which was raised and that justified the biopsy report. Conclusion: Unusual presentations of sarcoidosis pose a diagnostic challenge and warrant attention. Keywords - Sarcoidosis, Unusual, Rare, Case Report, Unilateral, Lung Mass, Granulomatous, Non-Caseating Granulomatous Mass, Lesion.