scholarly journals Sarcoidosis with Rare Extrapulmonary Involvement

2021 ◽  
Author(s):  
Marta Brandão Calçada ◽  
Sara Montezinho ◽  
Andreia M Teixeira ◽  
Bruno Gomes ◽  
Bernardo Macedo
Keyword(s):  
Epithelioid Cell ◽  
Lymphoproliferative Disease ◽  
Emission Tomography ◽  
Lumbar Pain ◽  
Positron Emission Tomography Scan ◽  
Erythrocyte Sedimentation ◽  
Positron Emission ◽  
Laboratory Results ◽  
Slight Elevation ◽  
Tomography Scan

Sarcoidosis is a systemic granulomatous disease in which medullary involvement is a rare extrapulmonary manifestation. We present the case of a 37-year-old man with right abdominal and dorso-lumbar pain lasting for months. Computerized tomography showed renal microlithiasis and retroperitoneal, hilar and mediastinal adenopathies. Laboratory results showed an elevated erythrocyte sedimentation rate, IgG, ?2-microgobulin and angiotensin-conversion enzyme, serum calcium in the upper limit and hypercalciuria. There was a slight elevation of the CD4/CD8 ratio in bronchoalveolar lavage, without lymphocytic alveolitis. An endobronchial ganglion biopsy was inconclusive. A positron emission tomography scan demonstrated supra and infra-diaphragmatic, splenic and medullary involvement, suggesting lymphoproliferative disease (LPD). A bone marrow biopsy (BMB) revealed sarcoid-like epithelioid cell granulomas, excluding LPD. Sarcoidosis was assumed and corticosteroids were started. Although cytopenias were not present, the extensive ganglion, splenic and medullary involvement made LPD exclusion imperative, while BMB allowed for a definitive diagnosis.

scholarly journals Posterior Pharyngeal Wall Tuberculosis—A Forgotten Entity Mimicking Malignancy

2020 ◽  
pp. 014556132097378
Author(s):  
Arvind Kumar Kairo ◽  
Smile Kajal ◽  
Shamim Ahmed Shamim ◽  
Adarsh Barwad
Keyword(s):  
Posterior Pharyngeal Wall ◽  
Giant Cells ◽  
Epithelioid Cell ◽  
Emission Tomography ◽  
Positron Emission Tomography Scan ◽  
Pharyngeal Wall ◽  
Positron Emission ◽  
Type Giant ◽  
Anti Tubercular Therapy ◽  
Tomography Scan

Background: Tuberculosis (TB) of posterior pharyngeal wall (PPW), either primary or secondary, is extremely rare and can mimic malignancy in elderly patients. Case Report: A 36-year-old female patient presented with complains of nonhealing ulcer at the back of her throat for 4 months. On examination, there was an ulceroproliferative growth covered with slough over PPW. Positron emission tomography scan showed uptake in PPW. There was no uptake in any other part of body. A biopsy from PPW lesion showed epithelioid cell granulomas with Langhans type giant cells. Auramine-rhodamine staining showed few beaded bacilli consistent with TB. Conclusion: Tuberculosis of PPW is an extremely uncommon entity and can mimic malignancy. It should be kept as one of the differential diagnosis as it can be cured solely by giving anti-tubercular therapy.

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