{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T04:29:04Z","timestamp":1769747344130,"version":"3.49.0"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,17]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Sarcoidosis is a multisystem granulomatous disease that can mimic tuberculosis (TB) or lymphoma, particularly in endemic regions. We report a man in his late 50s with chronic cough, weight loss and systemic features whose CT showed mediastinal and abdominal lymphadenopathy with splenic lesions. Histology from endobronchial ultrasound-guided transbronchial cryobiopsy revealed non-caseating granulomas, confirming sarcoidosis and excluding TB and malignancy. He responded well to corticosteroids with methotrexate as a steroid-sparing agent. This case emphasises the diagnostic challenge of sarcoidosis in TB-endemic regions and highlights the added value of cryobiopsy in obtaining adequate tissue for diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2025-270697","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:40:23Z","timestamp":1769697623000},"page":"e270697","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic sarcoidosis in a TB-endemic region: diagnostic role of linear endobronchial ultrasound mediastinal lymph node cryobiopsy and stepwise management approach"],"prefix":"10.1136","volume":"19","author":[{"given":"Sze Kye","family":"Teoh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Ampang, Ampang Jaya, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching Bing","family":"Jordan Hoo","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sarawak General Hospital, Kuching, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noor Afidah","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sarawak Government, Kuching, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sze Shyang","family":"Kho","sequence":"additional","affiliation":[{"name":"Division of Respiratory, Department of Medicine, Sarawak General Hospital, Kuching, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"2026012906401868000_19.1.e270697.1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1001\/jama.2022.1570","article-title":"Diagnosis and Treatment of Pulmonary Sarcoidosis: A Review","volume":"327","author":"Belperio","year":"2022","journal-title":"JAMA"},{"key":"2026012906401868000_19.1.e270697.2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-227929","article-title":"Multisystemic sarcoidosis-important lessons learnt from one of the great imitators","volume":"12","author":"Santosa","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2026012906401868000_19.1.e270697.3","unstructured":"Amin EN , Closser DR , Crouser ED . Current best practice in the management of pulmonary and systemic sarcoidosis. SAGE Open Med 2020."},{"key":"2026012906401868000_19.1.e270697.4","doi-asserted-by":"crossref","unstructured":"Li Z , Li X , Song Z , et al . Sarcoidosis misdiagnosed as malignant tumours: a case report. 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A systematic review","volume":"218","author":"Botana-Rial","year":"2023","journal-title":"Respir Med"},{"key":"2026012906401868000_19.1.e270697.9","doi-asserted-by":"crossref","DOI":"10.1183\/23120541.00448-2022","article-title":"Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy in the diagnosis of mediastinal lesions: safety, feasibility and diagnostic yield - experience in 50 cases","volume":"9","author":"Ariza-Prota","year":"2023","journal-title":"ERJ Open Res"},{"key":"2026012906401868000_19.1.e270697.10","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.04079-2020","article-title":"ERS clinical practice guidelines on treatment of sarcoidosis","volume":"58","author":"Baughman","year":"2021","journal-title":"Eur Respir J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:40:27Z","timestamp":1769697627000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,29]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-270697"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270697","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}