Ewha Med J.  2016 Apr;39(2):61-64. 10.12771/emj.2016.39.2.61.

Sarcoidosis Presenting with Multiple Lung Parenchymal Nodules

• Kim HJ
• Park J
• Kim JM
• Lee YJ
• Kang HR
• Lee CH

• KMID: 2171367
• DOI: http://doi.org/10.12771/emj.2016.39.2.61

Abstract

Sarcoidosis is a multi-organ disease with various clinical manifestations. The lung is the most common site of manifestation; however, unusual findings may delay the correct diagnosis of sarcoidosis. Here we report a case of 32-year-old man with 4-month history of neck mass. Radiological findings revealed multiple pulmonary parenchymal nodules, with initial biopsy results of his neck lymph node showing chronic granuloma with focal necrosis. The patient was treated with anti-tuberculosis medications, but the size of the nodules did not change. Biopsy was performed from one of his pulmonary nodules, which revealed chronic granuloma without necrosis. Therefore, the patient was diagnosed with sarcoidosis. We present a case of sarcoidosis with multiple lung parenchymal nodules that is uncommon in Korea, with an aim to alert physicians of such unusual presentations.

Keyword

Sarcoidosis; Multiple pulmonary nodules; Granuloma

MeSH Terms

Adult
Biopsy
Diagnosis
Granuloma
Humans
Korea
Lung*
Lymph Nodes
Multiple Pulmonary Nodules
Neck
Necrosis
Sarcoidosis*

Figure

• 

  Fig. 1 Initial simple chest radiograph. It reveals hilar lymph node enlargement with multiple parenchymal lung nodules.

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  Fig. 2 Chest computed tomography (CT) findings. It reveals bilateral mediastinal lymph node enlargement, and multiple lung parenchymal nodules. Decreased size of lymph nodes and lung nodules are shown (arrows). Initial (A, C) and 1-year follow-up (B, D) CT.

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  Fig. 3 Tissue biopsy findings. Right neck lymph node biopsy specimen of the patient with sarcoidosis reveals multiple chronic granulomatous inflammations without necrosis (arrow). (A) H&E, ×10; (B) H&E, ×40.

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