ABSTRACT
The nervous system is affected in 10 percent of patients with sarcoidosis. However, neurological disturbances are rarely the frst manifestation of the disease. We report a 36-year-old woman presenting with partial seizures that generalized secondarily. Magnetic resonance showed a left parietal cortical-subcortical lesion with a minimal mass effect, moderate vasogenic edema and intense enhancement with intravenous contrast. A magnetic resonance spectroscopy disclosed a low aggressiveness profle, compatible with an infammatory lesion. Angiotensin converting enzyme levels were normal. The lesion was excised and the pathological study showed the presence of granulomas with dubious necrosis. The patient was treated with antituberculous drugs. One year later, the lesion had grown and a thorax CT scan showed numerous mediastinal and hilar lymphadenopathies. A new determination of angiotensin converting enzyme disclosed elevated levels and the biopsy of mediastinal lymph nodes confrmed the presence of sarcoidosis.
Subject(s)
Adult , Female , Humans , Epilepsies, Partial/etiology , Sarcoidosis, Pulmonary/complications , Peptidyl-Dipeptidase A/bloodSubject(s)
Humans , Male , Adult , Sarcoidosis, Pulmonary/diagnosis , Hemoptysis/etiology , Sarcoidosis, Pulmonary/complications , Time Factors , Weight LossABSTRACT
No abstract available.
Subject(s)
Adult , Female , Humans , Cough/etiology , Diagnosis, Differential , Dyspepsia/etiology , Lung/diagnostic imaging , Sarcoidosis, Pulmonary/complications , Tomography, X-Ray Computed/methodsABSTRACT
Pulmonary cavitation is rather uncommon in patients with sarcoidosis, and aspergilloma is even more uncommon in such cases. Here, we present the case of a 63-year-old female patient with cavitary lung disease who had been under treatment for TB for 9 months. A diagnosis of pulmonary sarcoidosis was established based on the fiberoptic bronchoscopy finding of noncaseating granuloma. Treatment with corticosteroids led to a dramatic improvement in symptoms. While under treatment for sarcoidosis, the patient developed an aspergilloma. She presented immediate skin test reactivity to Aspergillus fumigatus, as well as positivity for A. fumigatus serum precipitins. This is the first reported case of aspergilloma formation in a patient with cavitary sarcoidosis in India.
A cavitação pulmonar é rara em pacientes com sarcoidose, e o aspergiloma é ainda mais raro nestes casos. Apresentamos o caso de uma paciente de 63 anos com doença pulmonar cavitária em tratamento para a TB por 9 meses. Estabeleceu-se o diagnóstico de sarcoidose pulmonar com base nos achados de granuloma não-caseoso na fibrobroncoscopia. Houve grande melhora dos sintomas com o tratamento com corticosteroides. A paciente desenvolveu um aspergiloma durante o tratamento para a sarcoidose. Houve reação imediata ao teste cutâneo para Aspergillus fumigatus, assim como resultado positivo para precipitinas de A. fumigatus no soro. Este é o primeiro caso relatado de formação de aspergiloma em um paciente com sarcoidose com cavitação na Índia.
Subject(s)
Female , Humans , Middle Aged , Aspergillus fumigatus , Aspergillosis/microbiology , Lung Diseases, Fungal/microbiology , Sarcoidosis, Pulmonary/complications , Aspergillus fumigatus/immunology , Biomarkers/blood , Precipitins/blood , Sarcoidosis, Pulmonary/drug therapyABSTRACT
The clinical appearance and imaging findings of sarcoidosis and breast carcinoma may sometimes mimic one another, making the differential diagnosis between these two diseases difficult in some cases. A 69-year-old woman displayed an irregular shaped lesion in her left breast. Preoperative localization modalities detected a breast mass with malignant characters. The patient also was found to have pulmonary findings for metastatic disease on chest computed tomography. These features were proven upon biopsy to be consistent with sarcoidosis. The patient underwent breast surgery, adjuvant chemoradiotherapy and hormonal therapy, while corticosteroids were administered for pulmonary sarcoidosis. The patient is well 12 months later, without recurrence. An unfortunate consequence of the presence of both entities in the same patient is the risk of misguided differential diagnosis and incorrect therapeutic strategy. This patient shows the importance of confirming a clinical diagnosis of sarcoidosis with appropriate biopsies and histological examination, prior to initiation of breast cancer therapy.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Aged , Antineoplastic Agents/therapeutic use , Breast Neoplasms/complications , Combined Modality Therapy , Diagnosis, Differential , Female , Humans , Lung Neoplasms/secondary , Radiotherapy , Sarcoidosis, Pulmonary/complicationsABSTRACT
Paciente masculino, 27 anos, com sintomas respiratórios, linfonodomegalia cervical anterior bilateral e hepatomegalia. Os estudos de imagem evidenciaram linfonodomegalia hilar bilateral e infiltrado pulmonar. O paciente foi submetido a biópsias pulmonar e hepática, que evidenciaram presença de granulomas não caseosos. Também foi submetido à biópsia de linfonodo hilar, que revelou a presença de material amilóide. Os achados clínicos, radiológicos e histopatológicos foram compatíveis com sarcoidose e amiloidose ganglionar. A associação entre sarcoidose e amiloidose é raramente descrita.
A 27-year-old male patient presented with respiratory symptoms, bilateral enlargement of the cervical lymph nodes and enlarged liver. In the imaging studies, bilateral enlargement of the hilar nodes was observed, together with pulmonary infiltrate. The patient was submitted to lung and liver biopsies, which revealed noncaseating granulomas. The clinical, radiological and histopathological findings were consistent with sarcoidosis and lymph node amyloidosis. The combination of sarcoidosis and amyloidosis has rarely been reported.
Subject(s)
Adult , Humans , Male , Amyloidosis/diagnosis , Mediastinal Diseases/diagnosis , Sarcoidosis, Pulmonary/diagnosis , Amyloidosis/complications , Amyloidosis/pathology , Biopsy , Granuloma/pathology , Liver/pathology , Mediastinal Diseases/complications , Mediastinal Diseases/pathology , Sarcoidosis, Pulmonary/complications , Sarcoidosis, Pulmonary/pathology , Tomography, X-Ray ComputedABSTRACT
A sarcoidose é uma doença sistêmica, inflamatória, crônica, de etiologia desconhecida até o momento, que se caracteriza pelo acúmulo de linfócitos e fagócitos mononucleares com formação de granulomas não caseosos nos órgãos acometidos provocando, com isso, desarranjo em suas estruturas teciduais. Os órgãos mais afetados costumam ser os pulmões, o sistema linfático, a pele e os olhos. Nesse relato, apresentamos um caso de sarcoidose pulmonar aguda, com febre, linfonodomegalia mediastinal e eritema nodoso, em uma mulher branca de 47 anos de idade que descobriu a doença após exame médico de rotina
Subject(s)
Humans , Female , Middle Aged , Erythema Nodosum , Sarcoidosis, Pulmonary/complicationsABSTRACT
A sarcoidose representa uma doença inflamatória cuja etiologia permanece desconhecida. Acomete principalmente o interstício pulmonar, com formação de granulomas não caseosos e adenomegalia. Trata-se de enfermidade sistêmica, portanto, pode atingir qualquer órgão ou sistema, devendo ser lembrada no diagnóstico diferencial das doenças infecciosas, neoplásicas ou auto-imunes, isto porque, se diagnosticada corretamente, evita medicações ou cirurgias desnecessárias. Os autores relatam um caso de sarcoidose pulmonar com envolvimento hepático, no qual o paciente desenvolveu cirrose e trombose de veia porta.
Subject(s)
Male , Middle Aged , Humans , Liver Diseases/diagnosis , Liver Diseases/etiology , Sarcoidosis, Pulmonary/complications , Sarcoidosis, Pulmonary , Abdomen , Liver/physiopathologyABSTRACT
OBJECTIVE: To study bronchial hyperresponsiveness (BHR) in patients with sarcoidosis. METHODS: Twenty freshly diagnosed patients with sarcoidosis were evaluated. Progressively increasing concentrations of methacholine were administered using a standard five-breath dosimeter protocol, and spirometry performed after each challenge. BHR was expressed as PC20 (provocating concentration of methacholine resulting in 20% fall in forced expiratory volume in first second). All patients were nonsmokers, had no other concurrent cardiopulmonary disease, and were not on any specific treatment for sarcoidosis. RESULTS: Borderline (PC20 4.0-16.0 mg/mL), mild (PC20 1.0-4.0 mg/mL) and moderate to severe (PC20 <1.0 mg/mL) BHR was documented in three (15%), one (5%) and five (25%) patients respectively. Patients with BHR were similar to those having normal reactivity in terms of age, gender, disease duration and results of pulmonary function testing. All patients with endobronchial disease had BHR. CONCLUSION: BHR may be seen in several patients of sarcoidosis and could possibly contribute to decline in lung function.
Subject(s)
Adult , Bronchial Hyperreactivity/classification , Bronchial Provocation Tests , Female , Humans , Lung Volume Measurements , Male , Methacholine Chloride/diagnosis , Sarcoidosis, Pulmonary/complications , Severity of Illness Index , SpirometryABSTRACT
We report a 52-year-old man with left-sided ulcerative colitis for 5 years and pulmonary sarcoidosis diagnosed 3 years back. He presented with subcutaneous lipomatosis and a right iliac fossa mass, which was diagnosed histologically as appendiceal adenocarcinoma. He was treated with right hemicolectomy, followed by chemotherapy.
Subject(s)
Adenocarcinoma/complications , Appendiceal Neoplasms/complications , Colitis, Ulcerative/complications , Combined Modality Therapy , Humans , Lipomatosis/complications , Male , Middle Aged , Sarcoidosis, Pulmonary/complications , Skin Diseases/complicationsSubject(s)
Humans , Sarcoidosis, Pulmonary , Sarcoidosis, Pulmonary/classification , Sarcoidosis, Pulmonary/complications , Sarcoidosis, Pulmonary/diagnosis , Sarcoidosis, Pulmonary/drug therapy , Sarcoidosis, Pulmonary/epidemiology , Sarcoidosis, Pulmonary/etiology , Sarcoidosis, Pulmonary/pathology , Sarcoidosis, Pulmonary/physiopathology , Sarcoidosis, Pulmonary/therapyABSTRACT
Se presenta el caso de una paciente de 28 años con un cuadro clínico de estenosis pulmonar severa; en el estudio hemodinámico se comprobó obstrucción a la salida del ventrículo derecho y el angiograma pulmonar demostró constricciones homogeneas en el calibre de los vasos pulmonares. En el estudio patológico post mortem se encontró un linfoma histiocítico del mediastino anterior que comprometía las estructuras vasculares del pedículo aortopulmonar