Bone Marrow involvement of Sarcoidosis, Case Report

Yıl 2015, , 105 - 108, 07.09.2015

Demet Çekdemir Serdar Olt Hasan Ergenç Yasemin Gündüz Aysel Gürkan Toçoğlu , Sümeyye Korkmaz Zeynep Kahyaoğlu Akkaya Bahar Memiş Ali Tamer

https://doi.org/10.5505/sakaryamj.2015.72692

Öz

Sarcoidosis is a systemic granulomatous disorder and most often involve in lung, rarely may present with bone marrow involvement. Hematologic anomalies can be determined in patients with bone marrow involvement, but it is not a rule. A 47-year-old woman patient having complaints from backache, difficulty in walking and weakness in bilateral lower extremities admitted to our hospital we detected bicytopenia and lesion in L2-L3 vertebrae. Patient was operated. After pathological investigation of lesion we diagnosed bone marrow involvement of sarcoidosis. Lung and the other organs systems were normal. A-74-year-old woman patient having complaints from malaise and fatigue admitted to our hospital, we detected pancytopenia and vertebral lesion than we applied bone marrow biopsy from the lesion. After bone marrow biopsy we diagnosed bone marrow involvement of sarcoidosis. In other investigations lung involvement with mediastinal lymphadenopathy was detected and the other organ systems were normal. Here we presented two cases diagnosed with bone marrow involvement of sarcoidosis which is seen rarely.

Anahtar Kelimeler

Sarcoidosis, Bone Marrow Involvement, Granuloma.

Sarkoidozda kemik iliği tutulumu, Olgu Sunumu

Öz

Sarkoidoz sistemik granülomatöz bir hastalıktır ve en sık akciğerleri tutar, nadir olarak kemik iliği tutulumu ile seyredebilir. Kemik iliği tutulumu olan hastalarda hematolojik anormallikler saptanabilmektedir. 47 yaşında bel ağrısı, yürümede güçlük ve çift taraflı alt ekstremitelerde güçsüzlük şikayetleri olan bayan hastada bisitopeni ve L2-L3 vertebrada lezyon saptandı. Hasta opere edildi. Lezyonun patolojik incelemesi sonucu sarkoidoz tanısı kondu. Yapılan diğer incelemeler sonucunda Akciğerde sarkoidoz tutulumu saptandı. 74 yaşında halsizlik ve yorgunluk şikayetleri olan bayan hastada yapılan tetkiklerde pansitopeni saptanması üzerine kemik iliği biyopsisi yapıldı. Kemik iliğinin patolojik olarak incelemesi sonucunda sarkoidozla uyumlu non-kazeifiye granülom saptandı. Yapılan diğer incelemelerde başka bir tutulum saptanmadı. Burada nadir görülen kemik iliği sarkoidozu saptanan iki olguyu sunduk.

Anahtar Kelimeler

Sarkoidoz, Kemik iliği tutulumu, Granülom

Kaynakça

• 1. Giovinale M, Fonnesu C, Soriano A, Cerquaglia C, Curigliano V, Verrecchia E,De Socio G, Gasbarrini G, Manna R. Atypical sarcoidosis: case reports and review of the literature. Eur Rev Med Pharmacol Sci. 2009 Mar;13 Suppl 1: 37-44.
• 2. Helbig G, Torba K, Pajak J, Kyrcz-Krzemie� S. Sarcoidosis with bone marrow involvement Pol Arch Med Wewn. 2014;124(7-8):427-8.
• 3. Lieberman J. Elevation of serum angiotensin-convertingenzyme (ACE) level in sarcoidosis Am J Med. 1975 Sep;59(3):365-72.
• 4. Soussan M, Augier A, Brillet PY, Weinmann P, Valeyre D. Functional imaging in extrapulmonary sarcoidosis: FDG-PET/CT and MR features Clin Nucl Med. 2014 Feb;39(2):e146-59. doi: 10.1097/RLU.0b013e318279f264.
• 5. Braun JJ, Kessler R, Constantinesco A, Imperiale A. 18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases. Eur J Nucl Med Mol Imaging. 2008 Aug;35(8):1537- 43. doi:10.1007/s00259-008-0770-9.
• 6. Brackers de Hugo L, French M, Broussolle C, et al. Granulomatous lesions in bone marrow: clinicopathologic findings and significance in a study of 48 cases. Eur J Intern Med. 2013; 24: 468-473.
• 7. Hameed OA, Skibinska M. Scar sarcoidosis with bone marrow involvement and associated musculoskeletal symptoms. BMJ Case Rep. 2011: bcr0220113863.
• 8. Shoughy SS(1), Jaroudi MO(1), Tabbara KF(2). Regression of peripapillary choroidal neovascular membrane in a patient with sarcoidosis after oral steroid therapy. Saudi J Ophthalmol. 2014 Apr;28(2):160-2. doi: 10.1016/j. sjopt.2014.02.007. Epub 2014 Mar 6.
• 9. Denys BG(1), Bogaerts Y, Coenegrachts KL, De Vriese AS. Steroid-resistant sarcoidosis: is antagonism of TNF-alpha the answer? Clin Sci (Lond). 2007 Mar;112(5):281-9.
• 10. Thongpooswan S, Abrudescu A. Lung sarcoidosis in etanercept treated rheumatoid arthritis patient: a case report and review of the literature. Case Rep Rheumatol. 2014;2014:358567. doi: 10.1155/2014/358567. Epub 2014 Jul 3.