A rare case of sarcoidosis with necrotizing mediastinal lymphadenitis misdiagnosed as multidrug-resistant tuberculosis (MDR- TB).

Sarcoidosis, a multisystem disorder of unknown cause, is characterized by the presence of non-caseating granulomas and the proliferation of epithelioid cells. Sarcoidosis mostly affects the lungs and mediastinal lymph nodes in 90% of cases. Caseation and necrosis are very rare. We report the present case in view of its rarity, as sarcoidosis with significant necrosis in mediastinal lymph nodes is a rare phenomenon and can mislead the treating physician into diagnosing it as tuberculosis, which can lead to exposure of the patient to undue side effects of anti-tubercular drugs.