A 46-year male, ex-smoker presented with cough and hoarseness for 2-3 months. The CECT chest revealed a left upper lobe mass. BAL was negative for AFB, GeneXpert, and malignant cells. The bronchial biopsy showed granuloma with no caseation and infiltration of lymphoid cells. The ultrasound abdomen was normal. The patient was started on prednisolone 0.5 mg/kg. He improved clinic-radiologically. Ex-smoker, middle-aged man with hoarseness and mass lesion on CECT chest is highly suspicious of lung malignancy. Pulmonary sarcoidosis should be kept in the differential diagnosis of unexplained hoarseness and mass lesion as the disease has diverse presentations.
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