The clinical presentation of tuberculosis can be varied and atypical, as suggested by a case study by Chokoeva et al. that raised issues regarding the differential diagnosis in the case of a 35-year-old patient with skin lesions (erythematous plaques with asymmetric distribution on the face), bilateral cervical adenopathy, bilateral hilar adenopathy, and micronodules with bilateral distribution predominantly in the middle-lower lung areas, in which the histopathological exam highlighted sarcoid-like granulomas, but with a positive interferon-gamma release assays (IGRAs) test. The gene discussed is IFNG; the disease is Granuloma.