Sarcoidosis Presenting as Colonic Polyposis: Report of a Case

A 47-year-old, West Indian male was referred for investigation of mild iron-deficiency anemia. He was asymptomatic. Two years earlier, he had an episode of transient facial weakness and a separate episode of diplopia. Gastroscopy and duodenal biopsies were normal. Barium enema demonstrated multiple small polyps throughout the colon. At colonoscopy, these polyps had the appearance of adenomatous polyps. Histology revealed noncaseous epithelioid granulomas. There were no acid-fast bacilli, no intervening colitis, and no features of Crohn’s disease on small-bowel radiology. Chest x-ray demonstrated bilateral hilar lymphadenopathy. A diagnosis of sarcoidosis with colonic involvement has been made. Sarcoid has been described at various sites in the gastrointestinal tract, presenting with stricturing or ulceration. There have been no previous reports of sarcoidosis presenting as discreet colonic polyps.