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Nodular sarcoidosis comprises less than 5% of cases of sarcoidosis and predominantly shows pulmonary infiltrations. Necrotizing sarcoid granulomatosis (NSG) was first described in 1973 by Liebow, and is best characterized as a variant of nodular sarcoidosis. NSG has the unique picture of infarction-like necrosis within granulomatous lesions, thereby posing a challenge of differentiating it from tuberculosis. Essentially, the diagnosis relies heavily on exclusion of possible causes of granulomatous inflammation. A 35-year-old man with fever and night sweating presented a personal history of significant exposure to pulmonary tuberculosis. His father, with whom he had close contact, had been diagnosed with open tuberculosis 6 months before onset of his symptoms. The sputum acid-fast stain and mycobacterial cultures for tuberculosis were both negative; however, a tuberculin skin test with purified protein derivative was positive by an increment of induration greater than 15 mm. Chest computed tomography (CT)

Endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) has been proven to be useful in lung cancer staging, but its application to benign lesions has been less studied. Bronchogenic cyst is a congenital anomaly in the tracheobronchial tree that is usually asymptomatic. Very large cysts may compress the trachea, causing respiratory symptoms. Relief of compression by EBUS-TBNA had been previously reported. Although rare, bronchogenic cyst may complicate with infection; however, accurate sampling is difficult for conventional TBNA due to blind approach. In this clinical setting, EBUS-TBNA provides real-time visualization, which may enable infection survey toward the lesions.