Pulmonary sarcoidosis with suspected bone marrow involvement presenting as severe thrombocytopenia: a case report

作者：Zhouzhou Li, Qianru Peng, Zheng Wang, Fei Xiang, Ronghui Liu, Zhigang Hu, Xinyu Song · 发表于：BMC Pulmonary Medicine · 年份：2026 · DOI：10.1186/s12890-026-04315-x · 研究领域：Sarcoidosis and Beryllium Toxicity Research、Myeloproliferative Neoplasms: Diagnosis and Treatment、Hematological disorders and diagnostics

BACKGROUND: Sarcoidosis is a multisystem granulomatous disorder of unclear etiology, with the lungs and mediastinal lymph nodes being the most frequently involved sites. Bone marrow involvement in sarcoidosis is extremely rare, and its presentation with severe thrombocytopenia as the dominant hematological abnormality is even more uncommon, which often results in clinical misdiagnosis. We report a case of pulmonary sarcoidosis with suspected bone marrow involvement presenting as severe thrombocytopenia, aiming to supplement the clinical evidence for such rare manifestations and provide a reference for clinical diagnosis and management. CASE PRESENTATION: A 60-year-old male was admitted to our hospital due to chest tightness, wheezing, and dyspnea lasting more than six months. Laboratory investigations revealed severe thrombocytopenia (platelet count 8×109/L), and chest computed tomography (CT) demonstrated enlargement of mediastinal and bilateral hilar lymph nodes, along with bilateral pulmonary infiltrates. Pulmonary function tests showed a restrictive ventilatory defect accompanied by severe impairment of pulmonary diffusion capacity. Bone marrow aspiration and biopsy suggested impaired platelet production by megakaryocytes, whereas endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes confirmed non-caseating granulomas, consistent with the diagnosis of sarcoidosis. The patient was diagnosed with stage II pulmonary sarcoidos...