Introduction Sarcoidosis is a systemic granulomatous disease of unknown etiology. The diagnosis of sarcoidosis is established on the basis of compatible clinical and radiologic findings, supported by histologic evidence of noncaseating epithelioid-cell granulomas in one or more organs Case A 66 year old man had suffered from Rt. Submental swelling before 7 months ago. He had chronic hepatitis B and had treated for 10 years. He also had cysticercosis on his brain 10 years ago but haven’t recurred. Physical examination revealed a palpable mass on the right side of his neck.Excisional bx was done and Tb PCR test was done. Pathologic result was Chronic caseating granulomatous inflammation. Conclusion A diagnosis of sarcoidosis is established on the basis of compatible clinical and radiologic findings and is supported by histologic evidence of noncaseating epithelioid-cell granulomas in one or more organs in the absence of organisms or particles.Chronic exposure to inflammatory stimuli and/or foreign bodies may contribute to the development of granulomatous disease. Therefore, other important differential diagnoses of granulomatous disease must be excluded.