Which combination best characterize sarcoidosis in terms of demographics and pathology?

• A. African-Americans with dry cough and hilar lymphadenopathy; non-caseating granulomas
• B. Caucasians with productive cough; caseating granulomas
• C. Asians with cavitary lesions; Ghon complex
• D. Hispanics with chest pain; caseating granulomas

Answer: (A)

Sarcoidosis is a multisystem granulomatous disease that most often affects young to middle-aged adults, with a higher incidence in African-Americans. In the lungs, it commonly presents with a dry cough and hilar lymphadenopathy on imaging. The defining tissue finding is non-caseating granulomas, meaning granulomas without central necrosis. This combination—African-American ethnicity, dry cough with hilar adenopathy, and non-caseating granulomas—best fits sarcoidosis. The other scenarios describe findings more typical of tuberculosis (productive cough with caseating granulomas, cavitary lesions, or Ghon complex) or different ethnic patterns, which are not characteristic of sarcoidosis.