Case Report
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KEMİK TUTULUMU İLE METASTATİK KANSERİ TAKLİT EDEN PULMONER SARKOİDOZ OLGUSU

Year 2022, Volume: 85 Issue: 1, 125 - 129, 25.01.2022
https://doi.org/10.26650/IUITFD.853034

Abstract

Sarkoidoz etyolojisi bilinmeyen, özellikle akciğer ile lenf bezlerini, cildi, gözleri ve diğer organları tutabilen; fakat nadiren kemik ve kemik iliğini tutan bir hastalıktır. Otuz dokuz yaşında, iliak kemikte maligniteyi taklit eden lezyonu olan, biyopsi ile sarkoidoz olduğu kanıtlanan bir erkek hastayı sunduk. Lenfoma veya metastatik kanser ayırıcı tanısı yapmak son derece zordu. Hastaya akciğer ve iliak kemikten birçok biyopsi yapıldı. Hepsinin sonucu nonnekrotizan granulomatöz inflamasyon olarak raporlandı. Hastaya kortikosteroid tedavisi başlandı. Steroid tedavisine yeterli yanıt alınamayan hastanın steroid tedavisine metotreksat ilave edildi. Bunun sonrasında klinik ve radyolojik iyileşme kaydedildi. Bu olguda, maligniteyi benign bir hastalıktan ayırt edebilmek ve tanıyı doğrulamak için yeni biyopsilerle ytekrarlanan histopatolojik değerlendirmenin öneminin vurgulanması hedeflendi.

References

  • 1. Brincker H. The sarcoidosis-lymphoma syndrome. Br J Cancer 1986;54(3):467-73. [CrossRef]
  • 2. Heinle R, Chang C. Diagnostic criteria for sarcoidosis. Autoimmunity Reviews 2014;13(4-5):383-7. [CrossRef]
  • 3. James DG, Neville E, Siltzbach LE. A worldwide review of sarcoidosis. Ann N Y Acad Sci 1976;278:321-34. [CrossRef]
  • 4. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160(2):736- 55.
  • 5. Costabel U, Bonella F, Ohshimo S, Guzman J. Diagnostic modalities in sarcoidosis: BAL, EBUS, and PET. Semin Respir Crit Care Med 2010;31(4):404-8. [CrossRef]
  • 6. Danila E, Norkūniene J, Jurgauskiene L, Malickaite R. Diagnostic role of BAL fluid CD4/CD8 ratio in different radiographic and clinical forms of pulmonary sarcoidosis. Clin Respir J 2009;3(4):214-21. [CrossRef]
  • 7. Kantrow SP, Meyer KC, Kidd P, Raghu G. The CD4/CD8 ratio in BAL fluid is highly variable in sarcoidosis. Eur Respir J 1997;10(12):2716-21. [CrossRef]
  • 8. Fernández-Ruiz M, Guerra-Vales JM, Castelbón-Fernández FJ, Llenas-García J, Rodríguez-Peralto JL, López-Lancho R, et al. Sarcoidosis presenting as an osteolytic skull lesion: a case report and review of literature on skull sarcoidosis. Clin Rheumatol 2007;26(10):1745-8. [CrossRef]

PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER

Year 2022, Volume: 85 Issue: 1, 125 - 129, 25.01.2022
https://doi.org/10.26650/IUITFD.853034

Abstract

Sarcoidosis is a disease of unknown etiology which can affect the lungs and lymph nodes, skin, eyes and other organs and, in rare cases, bones and bone marrow cells. We present a case of a 39-year-old male patient with an iliac bone involvement of sarcoidosis mimicking malignancy. Lymphoma and metastatic cancer proved a challenge to discard in differential diagnosis. He underwent multiple biopsies including tru-cut lung parenchyma and iliac bone biopsies. All of the biopsy specimens were reported as non-necrotising granulomatous inflammation. He underwent corticosteroid treatment. His response to the steroid treatment was insufficient so methotrexate was added to the corticosteroid therapy. Afterwards, clinical and radiological improvement was recorded. We aimed to highlight the utilization of taking new biopsies and histopathological re-evaluations in order to confirm the diagnosis and distinguish a benign disease from a malignant one.

References

  • 1. Brincker H. The sarcoidosis-lymphoma syndrome. Br J Cancer 1986;54(3):467-73. [CrossRef]
  • 2. Heinle R, Chang C. Diagnostic criteria for sarcoidosis. Autoimmunity Reviews 2014;13(4-5):383-7. [CrossRef]
  • 3. James DG, Neville E, Siltzbach LE. A worldwide review of sarcoidosis. Ann N Y Acad Sci 1976;278:321-34. [CrossRef]
  • 4. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160(2):736- 55.
  • 5. Costabel U, Bonella F, Ohshimo S, Guzman J. Diagnostic modalities in sarcoidosis: BAL, EBUS, and PET. Semin Respir Crit Care Med 2010;31(4):404-8. [CrossRef]
  • 6. Danila E, Norkūniene J, Jurgauskiene L, Malickaite R. Diagnostic role of BAL fluid CD4/CD8 ratio in different radiographic and clinical forms of pulmonary sarcoidosis. Clin Respir J 2009;3(4):214-21. [CrossRef]
  • 7. Kantrow SP, Meyer KC, Kidd P, Raghu G. The CD4/CD8 ratio in BAL fluid is highly variable in sarcoidosis. Eur Respir J 1997;10(12):2716-21. [CrossRef]
  • 8. Fernández-Ruiz M, Guerra-Vales JM, Castelbón-Fernández FJ, Llenas-García J, Rodríguez-Peralto JL, López-Lancho R, et al. Sarcoidosis presenting as an osteolytic skull lesion: a case report and review of literature on skull sarcoidosis. Clin Rheumatol 2007;26(10):1745-8. [CrossRef]
There are 8 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Ece Şahinoğlu 0000-0002-3422-6433

Ahmet Hamdi Ilgazlı 0000-0001-9017-2014

Publication Date January 25, 2022
Submission Date January 4, 2021
Published in Issue Year 2022 Volume: 85 Issue: 1

Cite

APA Şahinoğlu, E., & Ilgazlı, A. H. (2022). PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER. Journal of Istanbul Faculty of Medicine, 85(1), 125-129. https://doi.org/10.26650/IUITFD.853034
AMA Şahinoğlu E, Ilgazlı AH. PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER. İst Tıp Fak Derg. January 2022;85(1):125-129. doi:10.26650/IUITFD.853034
Chicago Şahinoğlu, Ece, and Ahmet Hamdi Ilgazlı. “PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER”. Journal of Istanbul Faculty of Medicine 85, no. 1 (January 2022): 125-29. https://doi.org/10.26650/IUITFD.853034.
EndNote Şahinoğlu E, Ilgazlı AH (January 1, 2022) PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER. Journal of Istanbul Faculty of Medicine 85 1 125–129.
IEEE E. Şahinoğlu and A. H. Ilgazlı, “PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER”, İst Tıp Fak Derg, vol. 85, no. 1, pp. 125–129, 2022, doi: 10.26650/IUITFD.853034.
ISNAD Şahinoğlu, Ece - Ilgazlı, Ahmet Hamdi. “PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER”. Journal of Istanbul Faculty of Medicine 85/1 (January 2022), 125-129. https://doi.org/10.26650/IUITFD.853034.
JAMA Şahinoğlu E, Ilgazlı AH. PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER. İst Tıp Fak Derg. 2022;85:125–129.
MLA Şahinoğlu, Ece and Ahmet Hamdi Ilgazlı. “PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER”. Journal of Istanbul Faculty of Medicine, vol. 85, no. 1, 2022, pp. 125-9, doi:10.26650/IUITFD.853034.
Vancouver Şahinoğlu E, Ilgazlı AH. PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER. İst Tıp Fak Derg. 2022;85(1):125-9.

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