ABSTRACT Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology that predominantly affects the lungs and intrathoracic lymph nodes. Pleural involvement is uncommon, and sarcoidosis‐associated pleural effusion (SAPE) represents a rare clinical manifestation, reported in approximately 1% of cases. We describe a 24‐year‐old male presenting with bilateral pleural effusion and mediastinal lymphadenopathy. Comprehensive diagnostic evaluation revealed a lymphocyte‐predominant exudative pleural effusion with negative microbiological and cytological findings. Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) demonstrated non‐caseating granulomas consistent with sarcoidosis. Elevated serum angiotensin‐converting enzyme (ACE), soluble interleukin‐2 receptor (sIL‐2R), and serum amyloid A (SAA) supported active disease. The patient achieved complete clinical, biochemical and radiological remission following systemic corticosteroid therapy. This case highlights the importance of a rigorous differential diagnostic approach and careful clinicoradiological–histopathological correlation in rare presentations of sarcoidosis.
Thaçi et al. (Wed,) studied this question.