A young lady presented with bilateral nodular lesions on shins. She was also found to have bilateral hilar lymphadenopathy on chest X-ray. Mantoux test reveals indurations of 5 mms. A skin biopsy would reveal –
**Core Concept**
The clinical presentation suggests **sarcoidosis**, a systemic granulomatous disease characterized by the formation of non-caseating granulomas in various organs, including the lungs and skin. The presence of bilateral hilar lymphadenopathy on chest X-ray is a hallmark of pulmonary sarcoidosis.
**Why the Correct Answer is Right**
The correct answer is related to the histopathological findings in sarcoidosis. A skin biopsy from the nodular lesions would reveal non-caseating granulomas, which are aggregates of epithelioid cells, macrophages, and lymphocytes. These granulomas are characteristic of sarcoidosis and can be found in various organs affected by the disease.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not describe the characteristic histopathological findings of sarcoidosis.
**Option B:** This option is also incorrect as it does not correlate with the clinical presentation and histopathological features of sarcoidosis.
**Option C:** This option is incorrect because it is not related to the disease process described in the clinical scenario.
**Clinical Pearl / High-Yield Fact**
Sarcoidosis is a diagnosis of exclusion, and a high index of suspicion is required to diagnose this condition. The presence of non-caseating granulomas on biopsy is a key diagnostic feature.
**Correct Answer:** D. Non-caseating granulomas.