Sarcoidosis with Pancreatic Mass, Endobronchial Nodules, and Miliary Opacities in the Lung

Abstract

Abstract:Sarcoidosis affects multiple organs and rarely has unusual manifestations. A 78-year-old woman was referred to our hospital for coughing symptoms. A chest computed tomography (CT) scan revealed bilateral diffuse miliary patterns and right pleural effusion. Bronchoscopy showed multiple nodules in the carina and the bronchus intermedius. A CT scan of her abdomen revealed hypovascular lesions involving the pancreatic head and body. A transbronchial lung biopsy, bronchial mucosal biopsy, and endoscopic ultrasound-guided fine-needle aspiration of the pancreatic mass demonstrated non-caseating granulomas. We diagnosed the patient with sarcoidosis. She received no treatment for sarcoidosis and has been followed up for one year, during which no pulmonary disease progression had been observed and the pancreatic masses partially regressed.

Diffuse Lung Metastases in EGFR-Mutant Non-Small Cell Lung Cancer

“…Miliary nodular pattern of disease has distinct radiologic features characterized by diffuse, bilateral infiltration of the lungs by tiny, typically 1–4 mm in size, nodules likened to millet seeds [24]. This finding is seen in numerous infectious and inflammatory etiologies, including tuberculosis, histoplasmosis, silicosis, and sarcoidosis [25,26,27,28,29,30]. Miliary nodular patterns have also been in the setting of metastatic disease, most notably with primary thyroid cancer, renal cell carcinoma, and melanoma [24,25].…”

Isolated Pancreatic Sarcoidosis Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration

“…Patients with symptomatic pancreatic sarcoidosis present with abdominal pain, weight loss, obstructive jaundice, emesis, and related symptoms. However, patients with pancreatic sarcoidosis may be asymptomatic (12,15). Our patient had no symptoms, and the pancreatic masses were incidentally found during an assessment of diabetes mellitus.…”

“…There are cases that require surgery to diagnose the underlying condition correctly ( 18 - 21 ). Only a few reports have described cases where pancreatic sarcoidosis was diagnosed using EUS-FNA, and all of these cases consisted of patients with systemic sarcoidosis that affected the pancreas and other organs ( 14 , 15 , 22 ). To our knowledge, this is the first case of isolated pancreatic sarcoidosis diagnosed by EUS-FNA.…”

“…Most reports have described cases of pancreatic sarcoidosis diagnosed by a surgical biopsy (12,13). Only a few case reports have described the diagnosis of pancreatic sarcoidosis using endoscopic ultrasound-guided fine-needle aspiration ( EUS-FNA) (14,15,23).…”

Pancreatic sarcoidosis mimicking neoplasia: Case report

“…We report a case of sarcoidosis manifesting as a retention cyst of the pancreas. Pancreatic sarcoidosis in a living patient is a rare entity; the characteristic granulomas are usually found postmortem [ 4 ]. This particular patient did not seem to show any symptoms of his previously diagnosed sarcoidosis, despite the lesion in the pancreas.…”