Table 4.
Key Differential Diagnoses for Sarcoidosis within Individual Organ Systems
| Organ System | Noninfectious Differential Diagnoses | Infectious Differential Diagnoses |
|---|---|---|
| Central nervous system | IgG4-related disease | Bacteria |
| Chronic variable immunodeficiency | • Tuberculosis | |
| Rosai-Dorfman disease | • Brucella | |
| Histiocytoses | Fungi | |
| • Histiocytosis X | • Aspergillus | |
| • Erdheim-Chester | • Coccidioidomycosis | |
| Lymphomatoid granulomatosis | • Cryptococcosis | |
| Granulomatosis with polyangiitis | Parasites | |
| Rheumatoid nodules | • Amoeba | |
| Amyloidosis | • Toxoplasmosis | |
| Cholesterol granuloma | • Schistosomiasis | |
| Foreign body | • Taenia solium | |
| Drugs/toxins/heavy metals | • Echinococcus | |
| Sarcoid-like reaction to tumor | • Paragonimiasis | |
| CNS malignancies ranging from glioblastoma to lymphoma | Viruses | |
| • Varicella zoster | ||
| • Herpes simplex | ||
| Eyes | Inflammatory bowel disease | Parinaud oculoglandular syndrome |
| ANCA vasculitides | • Bartonella | |
| Vogt-Koyanagi-Harada disease | • Francisella | |
| Blau syndrome | Bacteria | |
| • Tuberculosis | ||
| • Syphilis | ||
| Viruses | ||
| • Cytomegalovirus | ||
| • Varicella zoster | ||
| Toxoplasmosis | ||
| Sinonasal | Granulomatosis polyangiitis | Bacteria |
| Eosinophilic granulomatosis with polyangiitis | • Tuberculosis | |
| Cholesterol granuloma | • Atypical | |
| NK/T-cell lymphoma | Mycobacteria | |
| Foreign body | • Klebsiella | |
| Drugs/toxins | Rhinoscleromatis | |
| • Cocaine | • Syphilis | |
| • Narcotics | Fungi | |
| • Aspergillus flavus | ||
| • Histoplasmosis | ||
| Parasites | ||
| • Leishmaniasis | ||
| • Rhinosporidiosis | ||
| Parotid/salivary/lacrimal glands | Granulomatosis polyangiitis | Bacteria |
| Ductal obstruction (calculus, tumor) | • Tuberculosis | |
| Crohn’s disease | • Atypical mycobacteria | |
| Heart | Giant cell myocarditis | Bacteria |
| Acute rheumatic heart disease | • Tuberculosis | |
| Granulomatosis with polyangiitis | • Syphilis | |
| Erdheim-Chester | • Tropheryma whippelii | |
| Arrhythmogenic right ventricular dysplasia | Fungi | |
| Foreign body | • Aspergillus | |
| Drugs/toxins | ||
| Granulomatous lesions of unknown significance | ||
| Spleen | Chronic variable immunodeficiency | Bacteria |
| Sarcoid-like reaction to tumor | • Tuberculosis | |
| Fungi | ||
| • Histoplasmosis | ||
| Parasites | ||
| • Leishmaniasis | ||
| Kidney | Granulomatosis polyangiitis | Bacteria |
| Chronic lymphocytic leukemia | • Tuberculosis | |
| Drugs | Fungi | |
| • Allopurinol | • Histoplasmosis | |
| • Antivirals | • Coccidioidomycosis | |
| • Anticonvulsants | Viral | |
| • β-Lactams | • Adenovirus | |
| • Diuretics | ||
| • Erythromycin | ||
| • Fluoroquinolones | ||
| • NSAIDs | ||
| • Proton pump inhibitors | ||
| • Rifampin | ||
| • Sulfonamides | ||
| • Vancomycin | ||
| Muscle | Non-Hodgkin lymphoma | Bacteria |
| Crohn’s disease | • Tuberculosis | |
| Thymoma-myasthenia gravis | • Syphilis | |
| Foreign body | • Brucella | |
| Primary biliary cirrhosis (primary biliary cholangitis) | Fungi | |
| Cryofibrinogenemia | • Pneumocystis jirovecii | |
| • Cryptococcosis | ||
| Virus | ||
| • Human T-lymphotrophic virus 1 |
Definition of abbreviations: ANCA = antineutrophil cytoplasmic antibody; CNS = central nervous system; NK = natural killer; NSAIDs = nonsteroidal antiinflammatory drugs.