A 32 year-old-woman with symptoms of fatigue and night sweats was admitted to our ENT department in June 2018 with a suspected cervical adenopathy. She had a medical history for Hashimoto's thyroiditis in euthyroidism and thalassemia trait. Suspecting a lymphoma, we performed an excisional biopsy of the lymph node under general anesthesia. Unexpectedly the histopathological report revealed a chronic non-necrotizing granulomatous lymphadenitis with multinucleated giant cells in appearance similar to sarcoidosis. The CT scan revealed multiple pulmonary lymph nodes with the largest (8 mm) in the lower right lobe and multiple supra and infra-diaphragmatic lymph nodes. Blood chemistry tests reported lymphopenia and increased erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and angiotensin-converting enzyme (ACE). QuantiFERON-Tb Gold (QFT-G) and other blood tests were normal. Functional pneumological tests and cardiological tests resulted normal. She has been diagnosed with pulmonary sarcoidosis with a supra and infra-diaphragmatic lymph nodes involvement. The pulmonologist started a close follow-up. One year later in June 2019 the patient presented to our medical office with bilateral nasal obstruction, rhinorrhea and anosmia of recent onset. A flexible fiberoptic endoscopy evaluation of the nasal cavity revealed a bilateral inferior hypertrophy of turbinates with nasal secretions and mild swelling of tissues. The patient presented a nonspecific lesion of the posterior wall in the rhinoparyx with an adenoid-like appearance (Figure 1B). Suspecting a new localization of sarcoidosis, we performed an endoscopic biopsy of the lesion under local anesthesia that confirmed our suspect. Given the new localization of the disease, and new onset nasal symptoms, the patient started a systemic therapy with hydroxychloroquine and prednisone. At the present time, the patient has a good clinical status with a complete resolution of her anosmia and nasal congestion.