Challenging Diagnosis: Unmasking the Enigma of Imaging Findings with Lung Schwannomas.

Schwannomas are benign slow-growing tumors arising from the embryonic neural crest cells of the nerve sheaths of peripheral and cranial nerves, and they are a rare type of soft tissue mass that is usually always solitary. Generally, it grows in the head, neck, and flexor portions of the limbs, where many nerves are located. Schwannomas of the lung are extremely rare. Fewer than ten cases of schwannomas in this organ region have been reported in the existing literature. In this case report, a 40-year-old male non-smoker was hospitalized with occasional chest pain. His chest computed tomographic scan revealed a 3.8 cm space occupying lesion in the upper lobe of the right lung. This lesion has clear boundaries and uneven internal density. And it was concluded as a benign lesion possibility, it is preferred to be considered as a haematoma. This space occupying lesion was eventually confirmed as a schwannoma by needle biopsy tissues. Due to the presence in rare locations, such as the lung, the clinical presentation of this space occupying lesion is non-specific, making diagnosis difficult. The data presented in this case report can help clinicians to obtain information on the identification of this disease, which highlighted lung schwannoma as a differential diagnosis for patients with intermittent pain. It can also alert clinicians and radiologists to observe every detail of the radiology imaging findings.

Quadruple overlapping autoimmune diseases manifested as sarcoidosis with mediastinal lymphadenopathy: a case report.

We present a rare case of a 55-year-old female patient with quadruple overlapping autoimmune diseases, including vitiligo, autoimmune hypothyroidism, ulcerative colitis, and sarcoidosis with mediastinal lymphadenopathy. The patient had been suffering from vitiligo since 2003 and was diagnosed with autoimmune hypothyroidism and ulcerative colitis through thyroid ultrasound and colonoscopy, respectively. After physical examination, mediastinal lymph nodes enlargement was detected, and sarcoidosis was diagnosed through ultrasound bronchoscope-guided transbronchial needle aspiration (EBUS-TBNA), which is a quadruple overlapping sign of autoimmune disease of sarcoidosis that has not been reported previously. The patient was treated with oral Chinese medicine for leukoplakia, oral levothyroxine sodium tablets to control thyroid function, and Chinese medicine enema for colitis, with intermittent treatment for 2 years. Prednisone acetate was administered for 1 month to reduce the size of the enlarged lymph nodes. Our case highlights the importance of considering sarcoidosis as a potential diagnosis in patients with autoimmune diseases who present with mediastinal lymphadenopathy.