• Jun Hyeok Kim, Bo Da Nam, Jung Hwa Hwang, Dong Won Kim, Ki-Up Kim, and Young Woo Park.
• Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
• Medicine (Baltimore). 2021 Dec 10; 100 (49): e28208.

RationaleNecrotizing sarcoid granulomatosis (NSG) has recently been termed "sarcoidosis with NSG pattern" for the disease entity representing nodular sarcoidosis with granulomatous pulmonary angiitis. It is characterized by sarcoid-like granulomas, vasculitis, and a variable degree of necrosis. Its rarity and nonspecific clinical symptoms can easily lead to misdiagnosis or delayed diagnosis.Patient ConcernsWe report a 67-year-old female with a biopsy-confirmed sarcoidosis with NSG pattern mimicking pulmonary malignancy on initial chest computed tomography scan.DiagnosesSarcoidosis with NSG pattern.InterventionsThe patient underwent video-assisted thoracoscopic surgery with a lung biopsy. No further treatment was performed after the lung biopsy.OutcomesFollow-up imaging studies revealed spontaneous regression of the disease after 2 months.LessonsAwareness of this rare benign disease entity and overlapping radiologic manifestations with pulmonary malignancy or other granulomatous diseases can be helpful for making a precise diagnosis with a better differential diagnosis.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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