We report the coincidence of uncommon manifestations of sarcoidosis, e
ach confirmed by percutaneous needle biopsy, revealing noncaseating gr
anulomas. A patient presented with a thyroid nodule which demonstrated
noncaseating granulomas on biopsy. When pleural effusion subsequently
developed, pleural biopsy demonstrated noncaseating granulomas with n
o acid fast bacilli on stain or culture, and a diagnosis of sarcoidosi
s was made, Thyroid and pleural involvement are each rare manifestatio
ns of sarcoidosis, and are usually associated with extensive systemic
disease. The diagnosis of sarcoidosis requires the appropriate clinica
l presentation, compatible histologic findings, and evaluation for oth
er causes of granuloma formation.