Four Decades of Necrotizing Sarcoid Granulomatosis: What Do We Know Now?

Rosen, Yale

doi:10.5858/arpa.2014-0051-ra

Cited by 109 publications

(90 citation statements)

References 67 publications

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“…Sarcoidosis is an immune-mediated, complex inflammatory disease which represents abnormal immune response to various environmental factors in persons with genetic predisposition to granulomas (17,18,19,20). It is characterized by activation of macrophages and CD4+ cells, and by accumulation of mononuclear phagocytes forming non-caseating epithelial cellular granuloma (21,22).…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Sarcoidosis in a patient with left Hilar calcification of the lungs - A Case Report

Paravina

Ljubenović²,

Stanojević

et al. 2016

Serbian Journal of Dermatology and Venereology

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Sarcoidosis is an acquired idiopathic granulomatous disease, which is characterized by noncaseating epithelioid granulomas in organs and tissues. Most frequently it affects the lungs, liver, lymph nodes, skin, eyes and other organs. The cutaneous lesions appear in 20 -30% of patients with systemic manifestations, and in 25% of them they appear without systemic manifestations. Based on the histopathological characteristics, cutaneous lesions are divided into specific, characterized by cutaneous granuloma, and non-specific, which are not granulomatous. Moreover, they can be classified as typical and atypical. We are presenting a female patient with unilateral hilar calcification of the lungs, who exhibited plaque skin lesions typical for sarcoidosis, with a specific granulomatous histology and a favorable response to corticosteroid and antimalarial therapy.

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Section: Discussionmentioning

confidence: 99%

Cutaneous Sarcoidosis in a patient with left Hilar calcification of the lungs - A Case Report

Paravina

Ljubenović²,

Stanojević

et al. 2016

Serbian Journal of Dermatology and Venereology

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“…Histologically, the disease is characterized by sarcoid-like granulomas, granulomatous vasculitis involving the walls of muscular arteries and veins, and varying degrees of necrosis (3,4). The disease has a benign prognosis, and treatment consists of corticosteroids and immunosuppressive agents (5). This case demonstrates the severe destruction of pulmonary parenchyma caused by necrotizing sarcoid granulomatosis when the disease is misdiagnosed and not treated.…”

Section: Nekrotizan Sarkoid Granulomatozis: Ağır Seyreden Bir Olgu Nementioning

confidence: 96%

Necrotizing Sarcoid Granulomatosis: A Case with Severe Progression

Türk¹,

Türktaş²,

Köktürk³

et al. 2017

Respir Case Rep

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A 40-year-old man presented with a 10-year history of progressive dyspnea, recurrent hemoptysis, and fatigue. In 2004, he had been diagnosed with sarcoidosis based on an open lung biopsy. He refused any treatment and had irregular outpatient monitoring. He was an active smoker with no other comorbidities. His physical examination was unremarkable; oxygen saturation rate measured with pulse oximetry was 95% at admission. Retrospective analysis of his imaging studies revealed convergent, cavitating nodules in central areas (Figure 1). On his last chest computed tomography image, there were multiple cavities with air-fluid levels of a maximum diameter of 7.5 cm at left upper lobe and 9 cm at right upper lobe, and tree-in-bud pattern scattered through both lungs. There were no evident lymphadenopathies. Antinuclear antibody and anti-neutrophil cytoplasmic antibody test results were negative, angiotensin converting enzyme level was within normal limits, and serum galactomannan level was 1.71 (0-0.5 index). Sputum culture, acid-fast bacilli staining, and tuberculosis culture were all negative.Previous pathology specimens were reevaluated and the histology revealed multiple giant cell formations associated with several sarcoid-like granulomas in damaged lung parenchyma, and extended ischemic necrosis and granulomas in the vessel walls. The patient was diagnosed with necrotizing sarcoid granulomatosis (NSG) and aspergilloma.

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“…Ek olarak, hastanın eski lenf nodu patolojisinde, çevre kanın-dan yapılan genetik incelemelerde ve plevral sıvı sitolojisinde hematolojik tanı lehine bir bulgu izlenmemiş ve hastanın monositozunun ilk önce inflamatuvar hastalığıyla ilişkili olduğu öngörülerek, NSG tanısına yönelik glukokortikoid tedavisine başlanmıştır. NSG glukokortikoid tedavisine iyi yanıt vermektedir (1)(2)(3). Olgumuzda glukokortikoid tedavisine başlangıçta olumlu bir yanıt alınmış, ancak eşlik eden KMML nedeniyle hastanın hematolojik anormalliklerinde beklenen iyileşme gözlenmemiştir.…”

Section: Tartişma Ve Sonuçunclassified

“…NSG zemininde KMML gelişi-minin monosit ve makrofaj hücre gelişim yolaklarının ortak bir hastalığına bağlı olduğu ileri sürülmektedir (10). NSG şimdiye kadar literatürde yaklaşık 100 hastada bildirilmiş olup KMML de 1 milyonda 4 kişide gözlenen bir hastalıktır (1). Olgu, iki nadir hastalığın bir arada görülmesinin yanı sıra, reaktif veya klonal monositoza yol açan monositer seriye ait stimülasyon/proliferasyon anormalliklerini ortaklaşa barındıran NSG ve KMML'nin birbirlerini izleyerek gelişmesi açısından da önem taşımaktadır.…”

Section: Tartişma Ve Sonuçunclassified