Clinical Features of Sinonasal Sarcoidosis

 

Clinical features:

(1) friable nasal mucosa with crusting

(2) nasal congestion with mucosal edema

(3) epistaxis

(4) sinonasal pain

(5) anosmia

(6) nasal polyps

(7) submucosal nodules and/or plaques

(8) variable pharyngeal involvement

 

A history of sarcoidosis elsewhere can be helpful in making the diagnosis but may be absent.

 

Imaging studies:

(1) opacification of the sinuses

(2) thickening of the sinus mucosa

 

An initial workup may include:

(1) biopsy of the sinonasal mucosa to identify noncaseating granulomas or vasculitis

(2) culture of the sinonasal tissue

(3) serum angiotensin converting enzyme (ACE) activity

(4) syphilis serology

(5) fungal serology

(6) QuantiFERON testing

(7) absolute eosinophil count

(8) chest X-ray