Systemic sarcoidosis with significant granulomatous swelling of the pharyngeal tonsil.

A pharyngeal tonsil biopsy specimen from a 27-year-old male revealed epithelioid cell granulomas with noncaseating necrosis. Systemic enlargement of the lymph nodes was present. Plain chest radiographic and computed tomography (CT) images showed ground-glass attenuation in the lungs and bilateral hilar lymphadenopathy. Biopsy of inguinal region nodes confirmed the diagnosis of systemic sarcoidosis. Detailed examination of the nasopharynx should be performed in any case presenting with systemic sarcoidosis because the specimen is readily removable and the pathologic findings of the local lesion may support the diagnosis.