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Oral Sarcoidosis — MFDS Part 1 MCQ

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HardOral MedicineOral SarcoidosisMFDS Part 1

A 36-year-old woman has persistent painless nodular swellings of the labial mucosa and xerostomia. She also has bilateral parotid enlargement, low-grade fever, anterior uveitis and unilateral lower motor neurone facial palsy. Which histopathological finding in an oral biopsy would best support the unifying diagnosis?

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Correct answer: C — Non-caseating epithelioid granulomas with no demonstrable infective cause

The correct answer is C. Painless oral nodules and salivary-gland involvement may occur in sarcoidosis, for which the characteristic biopsy finding is non-caseating epithelioid granulomatous inflammation after infectious and other granulomatous causes have been excluded. Parotid enlargement, uveitis, fever and facial nerve palsy together constitute the classic complete form of Heerfordt syndrome. Caseating granulomas containing acid-fast bacilli suggest mycobacterial infection rather than sarcoidosis. Suprabasal acantholysis is characteristic of pemphigus vulgaris, while papillomatosis with koilocytosis supports an HPV-associated papillary lesion. Lichenoid interface inflammation with saw-tooth rete ridges is typical of oral lichen planus.

Reference: Salivary Gland Sarcoidosis: Systematic Review of Case Reports and Case Series, 2025. https://pubmed.ncbi.nlm.nih.gov/41226948/