Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Sep 3;12(9):e10220.
doi: 10.7759/cureus.10220.

A Rare Case Study About Necrotizing Granulomatous Sarcoidosis

Azka Tasleem  1 , Hamza Viquar  1 , Haris Noorani  1 , Ravi Savani  2 , Anchit Bharat  3
Affiliations
Case Reports

A Rare Case Study About Necrotizing Granulomatous Sarcoidosis

Azka Tasleem et al. Cureus. .

Abstract

Sarcoidosis is a granulomatous disorder with an elusive etiology and pathogenesis. Classically, sarcoidosis is associated with non-caseating granulomas composed of mononuclear phagocytes, lymphocytes, and multinucleated giant cells. Necrotizing granulomas can also be associated with sarcoidosis but is scarcely reported in the medical literature. Necrotizing sarcoid granulomatosis is challenging to diagnose due to its rarity and similarity with other necrotizing disorders. Therefore, it is mainly considered a diagnosis of exclusion. We report one such case study, which could prompt further research to lay the course of treatment strategies for this disease. Moreover, our patient had a family history of sarcoidosis, which raises questions regarding possible genetic predisposition, and future work might help solve this medical mystery.

Keywords: high-value care; necrotizing sarcoid granulomatosis; sarcoid.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT abdomen showing a transverse view of enlarged periportal lymph nodes measuring 2.4 cm × 5.3 cm in largest dimension (marked in white).
Figure 2
Figure 2. CT abdomen transverse section showing enlarged spleen measuring 13.49 cm in largest dimension (marked in white).
Figure 3
Figure 3. CT angiography chest transverse view showing bilateral pulmonary infiltrates.
Figure 4
Figure 4. CT angiography chest transverse view showing enlarged left anteroposterior lymph node measuring 2.1 cm × 3.7 cm (dimensions marked in white).
Figure 5
Figure 5. CT angiography chest transverse view showing extensively enlarged pathological hilar lymph nodes measuring 3.4 cm × 6.7 cm (dimensions marked in white).
Figure 6
Figure 6. CT angiography chest transverse view showing enlarged subcarinal lymph node measuring 3.7 cm × 5.4 cm (dimensions marked in white).
Figure 7
Figure 7. Fine needle aspiration cytology of subcarinal lymph node showing necrotic debris and lymphocytes (marked in red).
Figure 8
Figure 8. Fine needle aspiration cytology of subcarinal lymph node showing epithelioid histiocytes (marked in red).
See this image and copyright information in PMC

References

    1. Pulmonary sarcoidosis. Baughman RP. Clin Chest Med. 2004;25:521–530. - PubMed
    1. Atypical radiological manifestations of thoracic sarcoidosis: a review and pictorial essay. Al-Jahdali H, Rajiah P, Koteyar SS, Allen C, Khan AN. Ann Thorac Med. 2013;8:186–196. - PMC - PubMed
    1. Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization. Rybicki BA, Major M, Popovich J Jr, Maliarik MJ, Iannuzzi MC. Am J Epidemiol. 1997;145:234–241. - PubMed
    1. Diagnosis and detection of sarcoidosis. An official American Thoracic Society clinical practice guideline. Crouser ED, Maier LA, Wilson KC, et al. Am J Respir Crit Care Med. 2020;201:26–51. - PMC - PubMed
    1. The J. Burns Amberson lecture: pulmonary angiitis and granulomatosis. Liebow AA. https://pubmed.ncbi.nlm.nih.gov/4577269/ Am Rev Respir Dis. 1973;108:1–18. - PubMed

Publication types

LinkOut - more resources