Systemic sarcoidosis mimicking malignant metastatic disease

Hammen, Irena; Sherson, David; Davidsen, Jesper Rømhild

doi:10.3402/ecrj.v2.26761

Cited by 38 publications

(8 citation statements)

References 13 publications

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“…On excisional biopsy, however, the cervical lymph nodes showed a picture typical of sarcoidosis 52. A few more case reports mirror our cases in that the patient presents with multisystemic sarcoidosis involving the liver and bones as well 53 54. In their case report,53 Hammen et al presented a case with systemic sarcoidosis involving the liver, pancreas, lungs, mediastinal and intra-abdominal lymph nodes, and bones.…”

Section: Systemic Inflammatory Diseasessupporting

confidence: 73%

“…A few more case reports mirror our cases in that the patient presents with multisystemic sarcoidosis involving the liver and bones as well 53 54. In their case report,53 Hammen et al presented a case with systemic sarcoidosis involving the liver, pancreas, lungs, mediastinal and intra-abdominal lymph nodes, and bones. The diagnosis of sarcoidosis was confirmed by the presence of non-caseating granulomas on ultrasound-guided liver biopsy and transbronchial biopsy, and the patient received systemic glucocorticoids as appropriate treatment for the condition.…”

Section: Systemic Inflammatory Diseasessupporting

confidence: 65%

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Multisystemic sarcoidosis—important lessons learnt from one of the great imitators

2019

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We report a case of a woman who was admitted with a suspicion of metastatic malignancy of unknown primary origin. A few months prior to her admission, she presented to a rheumatologist with acute anterior uveitis, psoriasiform rashes and polyarthritis. A diagnosis of psoriatic arthropathy was made and she was treated accordingly. Soon after she presented with persistent back and right upper quadrant abdominal pain for which she had a CT scan done with evidence of hilar lymphadenopathy, liver hypodensities and lytic-sclerotic bone lesions. She was referred to our hospital for further investigations and management. After re-exploring her clinical presentation and further investigations (including a liver biopsy), a diagnosis of multisystemic sarcoidosis with ocular, reticuloendothelial, hepatic and skeletal involvement was made. The patient was started on systemic glucocorticoids and second line immunosuppressants and demonstrated significant clinical improvement with resolution of her liver granulomata on imaging and improvement in her back pain. The case illustrates the importance of a thorough clinical assessment, review of investigations and an open mind in the evaluation of a patient.

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Section: Systemic Inflammatory Diseasessupporting

confidence: 73%

Section: Systemic Inflammatory Diseasessupporting

confidence: 65%

Multisystemic sarcoidosis—important lessons learnt from one of the great imitators

2019

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“…Estimation on the incidence rate and prevalence proportion of sarcoidosis in Puerto Rico might have been affected by possible inaccuracies in the use of ICD codes assigned by the health care providers to diagnose sarcoidosis. Since sarcoidosis may mimic other chronic inflammatory or even malignant metastatic disease, 36 the risk of misclassification or over diagnosis of sarcoidosis cannot be excluded. The identification of sarcoidosis was based on diagnostic claims; therefore, we were unable to confirm the sarcoidosis cases through the access of medical records data (i.e.…”

Section: Discussionmentioning

confidence: 99%

Incidence, prevalence, and economic burden of sarcoidosis in Puerto Rico: Estimates from a government health insurance claims database

Scharbaai-Vázquez

Tremblay

2021

Chronic Illness

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Objectives To estimate the epidemiology of sarcoidosis in Puerto Rico. Methods Patients with a diagnosis of sarcoidosis between January 2015 and December 2018 were selected from the Puerto Rico Health Insurance Administration Administración de Seguros de Salud de Puerto Rico claims database. The International Classification of Diseases-Tenth Revision coding for sarcoidosis was used for case detection and utilization of health care services. Cases by sex and age were evaluated. Results A total of 488 individuals with sarcoidosis were identified over the 4-year study. The median age at diagnosis was 59 years old. The average annual incidence rate was 9.9/100,000. The baseline prevalence was 14.9 per 100,000. Females represented 68.4% of the cases. Patients with lung and unspecified sarcoidosis predominate with 45.6% and 28.2% of cases, respectively. Overall, the yearly cost of health care utilization and medications per patient was $234 and $13,638, respectively. Conclusions Annual incidence rate and the median age of sarcoidosis in Puerto Ricans are among the highest and oldest reported globally. The demographic profile of sarcoidosis in Puerto Rico presents a patient in the mid-to advanced age, mostly female. While costs for medications were relatively high for a patient with sarcoidosis, the economic burden of the disease to the national health care system is not substantial.

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“…Clearly de ned nodules in organ's tissue can mimic disseminated malignancy. 10,11 Apart from nodular form of sarcoidosis, there are other granulomatous diseases that may lead to multiple nodules in the lungs, giving the impression of lung metastases, such as histoplasmosis and pulmonary hyalinizing granuloma 12,13 . Adding to the confusion, a number of other diseases can produce multiple pulmonary nodules, including pneumoconiosis, infectious (such as disseminated tuberculosis, invasive aspergillosis, chickenpox and measles), noninfectious in ammatory diseases (rheumatoid nodules, Wegener's granulomatosis), arteriovenous malformations, amyloid and infarcts 11 .…”

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confidence: 99%

Indistinctly synchronous lung and base of the tongue adenocarcinoma: case report and discussion of possible patterns of disease development

Mamic¹,

Manojlović²,

Jerković³

et al. 2020

Rad Hrvatske akademije znanosti i umjetnosti

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Due to its varying and often mimicking appearance, sarcoidosis is considered one of the great imitators in medicine. A rare form of pulmonary sarcoidosis, the nodular form, can be mistaken for disseminated malignancy. We present the case of 38-year-old patient, whose chest x ray demonstrated a large number of pulmonary nodules, more than 1 cm in diameter, predominantly in a peripheral distribution, with bilaterally enlarged hila, thus making disseminated malignant disease a part of di erential diagnosis. e sight of multiple lung nodules can be very suggestive for metastatic disease and misleading in everyday clinical practice. Sarcoidosis, Mimicking, Malignant disease, Nodules, Radiology; Nodular pulmonary sarcoidosis N Zbog svoje raznolike prezentacije i brojnih sličnosti s drugim bolestima, sarkoidoza je znana kao veliki imitator u medicini. Jedan od oblika sarkoidoze, nodularna plućna sarkoidoza, lako se može zamijeniti s malignom diseminiranom bolešću. Prikazujemo slučaj 38-godišnjeg pacijenta, čiji je torakalni rendgenogram pokazao veći broj periferno smještenih plućnih nodusa promjera većih od 1 cm uz obostrano uvećane hiluse. Takav nalaz upućivao je na diseminiranu malign bolest kao jednu od diferencijalnih dijagnoza. Cilj ovog prikaza slučaja je podsjetiti kolege na nodularnu plućnu sarkoidozu kao jednu od mogućih dijagnoza u slučaju ovako sugestivnih nalaza kod pacijenata bez ranije poznate maligne bolesti.

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Systemic sarcoidosis mimicking malignant metastatic disease

Cited by 38 publications

References 13 publications

Multisystemic sarcoidosis—important lessons learnt from one of the great imitators

Multisystemic sarcoidosis—important lessons learnt from one of the great imitators

Incidence, prevalence, and economic burden of sarcoidosis in Puerto Rico: Estimates from a government health insurance claims database

Indistinctly synchronous lung and base of the tongue adenocarcinoma: case report and discussion of possible patterns of disease development

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