A 26-year-old African-American woman has bilateral hilar adenopathy, and radiography reveals multiple reticular densities in both lung fields. A bronchoscopic biopsy reveals granulomatous inflammation with multiple giant cells but no evidence of caseous necrosis. Which of the following is the most likely diagnosis?: (A) Aspergillosis, (B) Tuberculosis, (C) Histoplasmosis, (D) Sarcoidosis
Answer is D. The histologic hallmark of sarcoidosis is the finding of non-caseating granulomatous inflammation.Although this finding is not entirely specific. A non-necrotizing granulomatous response of the lung is rarely seen in patients with tuberculosis or deep-seated fungal infections. These infections usually have a necrotizing component.