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Sarcoidosis

Systemic granulomatous inflammatory disease which can affect all organ systems – primarily the lungs.

Genitourinary manifestation is rare.

Hilar lymphadenopathy in the chest is usual hallmark feature.

 

Scrotal involvement

Often presents as a solid, usually painless mass, in the epididymis or testis.

Can also present as scrotal skin lesions

 

Renal involvement

Hypercalcaemia common in sarcoidosis – at least 10 % – and hypercalciuria very common (60 %) – therefore stones common in patients with sarcoidosis. Also associated with nephrocalcinosis.

Macrophages in sarcoid granulomas synthesise 1α-hydroxylase, which increases production of 1,25-dihydroxycholecalciferol, which increases intestinal reabsorption of calcium and promotes bone resorption

Can develop pseudotumours – non caseating granulomas – which may mimic renal masses on imaging.