Abstract：
BACKGROUND: Sarcoidosis is a multisystem inflammatory disease with a variable presentation. The most characteristic feature of sarcoidosis is nonnecrotizing granulomas. However, when sarcoidosis presents with rare organ involvement, and biopsy shows necrosis, the diagnosis becomes challenging.
METHODS: Here, we present three cases of sarcoidosis with unusual organ involvement and biopsy findings of necrosis, leading to a delay in diagnosis and treatment. Case 1 was presented with lymphoreticular involvement within the intraparotid lymph node and genitourinary area. Biopsy from the epididymis showed necrosis, initially leading to treatment for tuberculosis (TB). Case 2 describes lymphoreticular involvement and cardiac symptoms. His cervical and bone marrow biopsies showed necrosis. Case 3\'s presentation was disseminated lymphadenopathy with hepatosplenomegaly, initially suspected as malignancy or TB.
CONCLUSIONS: While biopsy plays a significant role in diagnosing sarcoidosis, the presence of necrosis alone should not lead to its exclusion.
METHODS: Here, we present three cases of sarcoidosis with unusual organ involvement and biopsy findings of necrosis, leading to a delay in diagnosis and treatment. Case 1 was presented with lymphoreticular involvement within the intraparotid lymph node and genitourinary area. Biopsy from the epididymis showed necrosis, initially leading to treatment for tuberculosis (TB). Case 2 describes lymphoreticular involvement and cardiac symptoms. His cervical and bone marrow biopsies showed necrosis. Case 3\'s presentation was disseminated lymphadenopathy with hepatosplenomegaly, initially suspected as malignancy or TB.
CONCLUSIONS: While biopsy plays a significant role in diagnosing sarcoidosis, the presence of necrosis alone should not lead to its exclusion.
摘要：
背景：结节病是一种多系统炎症性疾病，表现可变。结节病的最典型特征是非坏死性肉芽肿。然而,当结节病表现为罕见的器官受累时，活检显示坏死，诊断变得具有挑战性。
方法：这里，我们介绍了三例结节病与异常器官受累和坏死活检结果，导致诊断和治疗的延误。病例1表现为颈动脉内淋巴结和泌尿生殖道区域的淋巴网状受累。附睾活检显示坏死，最初导致结核病（TB）的治疗。病例2描述了淋巴网状受累和心脏症状。他的宫颈和骨髓活检显示坏死。病例3表现为播散性淋巴结肿大伴肝脾肿大，最初怀疑为恶性肿瘤或结核病。
结论：虽然活检在结节病的诊断中起着重要作用，单独坏死的存在不应导致其排除。
方法：这里，我们介绍了三例结节病与异常器官受累和坏死活检结果，导致诊断和治疗的延误。病例1表现为颈动脉内淋巴结和泌尿生殖道区域的淋巴网状受累。附睾活检显示坏死，最初导致结核病（TB）的治疗。病例2描述了淋巴网状受累和心脏症状。他的宫颈和骨髓活检显示坏死。病例3表现为播散性淋巴结肿大伴肝脾肿大，最初怀疑为恶性肿瘤或结核病。
结论：虽然活检在结节病的诊断中起着重要作用，单独坏死的存在不应导致其排除。
