Leiomyoma with Granulomatous Inflammation: Tissue Confirmation of Sarcoidosis

Granulomatous inflammation of the uterus is rare, and sarcoidosis involving the uterus is even less common. Sarcoidosis is an idiopathic granulomatous disease that can affect any organ, but most typically involves the lungs, lymph nodes, spleen, liver, skin, and eye. Although it can be diagnosed clinically based on a constellation of symptoms, definitive diagnosis typically requires demonstration of non-infectious non-caseating granulomas on tissue biopsy. It is a diagnosis of exclusion, and other causes of granulomatous inflammation must be excluded. We report here a case of granulomatous inflammation involving a leiomyoma in a patient with a previous clinical diagnosis of sarcoidosis. This was the patient’s first tissue-based diagnosis of sarcoidosis and highlighted the importance of adequate sampling of routine surgical specimens, as they may harbor signs of systemic disease.