Case Report ARareCaseofSystemicSarcoidosisinaMiddle-AgedFemalewith a Solitary Thyroid Nodule Ayrton Bangolo , 1 John Bukasa Kakamba , 2,3 Ali Atoot, 4 Mohammad Jurri, 5 AshrafMahmoud, 5 ArthurOliverLo, 6 KunchangSong, 7 SyedSirajuddin, 4 andAdamAtoot 1 1 Department of Internal Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA 2 Endocrine and Metabolic Disorders Department, University Clinics of Kinshasa, Kinshasa, Democratic Republic of the Congo 3 Department of Endocrinology, University of Liege, Liege, Belgium 4 Department of Anesthesia, Hackensack University Medical Center, Hackensack, NJ, USA 5 Department of Family Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA 6 University of the East Ramon Magsaysay, Quezon City, Philippines 7 Department of Pathology, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ, USA Correspondence should be addressed to Ayrton Bangolo; ayrtonbangolo@yahoo.com Received 2 September 2021; Revised 22 November 2021; Accepted 9 December 2021; Published 21 December 2021 Academic Editor: Mihail A. Boyanov Copyright © 2021 Ayrton Bangolo et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sarcoidosis is a multisystem inflammatory disease characterized by the presence of noncaseating granulomas. Sarcoidosis can affect any organ of the body, the lung being the most affected. Sarcoidosis rarely affects the thyroid gland, and only a few cases of thyroid-related sarcoidosis have been reported in the literature. Herein, we report a case of systemic sarcoidosis with multiple organ involvement in a patient with a solitary left thyroid nodule and benign Fine Needle Aspiration (FNA) findings. e patient was eventually diagnosed with thyroid sarcoidosis using a core needle biopsy of the thyroid nodule. With this case report, we highlight the limitations of the FNA. is case report has the objective to encourage clinicians to include thyroid sarcoidosis in the differential diagnosis of thyroid nodules in patients with systemic sarcoidosis even with unremarkable FNA findings. 1. Introduction Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that affects individuals worldwide and is characterized pathologically by the presence of noncaseating granulomas in involved organs [1]. Up to 30 percent of patients present with extrapulmonary sarcoidosis [2]. Ap- proximately 8 percent of patients with sarcoidosis present with disease at extrapulmonary sites without lung in- volvement. In these patients, the skin is the most common site and accounted for nearly half of the patients [3]. yroid involvement results in diffuse goiter or solitary thyroid nodule [4]. Most patients with thyroid involvement remain euthyroid and only a few cases have been associated with hypothyroidism [5]. We report the case of a middle-aged female who presented for evaluation of hypercalcemia and was found to have systemic sarcoidosis and a solitary left thyroid nodule. e thyroid nodule was found to be un- remarkable on Fine Needle Aspiration (FNA), but sarcoid infiltration of the gland was revealed on Core Needle Biopsy. With this case report, we aim to encourage physicians to include sarcoidosis in the differential diagnosis of thyroid nodules even with normal FNA and recognize the limita- tions of FNA. 2. Case Presentation is is a 58-year-old female with a past medical history of Diabetes Mellitus and asthma who presented for evaluation of hypercalcemia. e patient was referred from the Primary Care Physician’s office after routine blood work revealed elevated calcium levels. Of note, the patient visited her Hindawi Case Reports in Endocrinology Volume 2021, Article ID 5231703, 4 pages https://doi.org/10.1155/2021/5231703