Immune Thrombocytopenia: A Rare Presentation of Pulmonary Sarcoidosis.

Thrombocytopenia may be the initial presentation of sarcoidosis, which is a systemic granulomatous disorder. Various pathophysiological mechanisms have been identified. Immune thrombocytopenia often has a severe presentation but may respond favourably to immunosuppressive therapy. There are no guidelines for the treatment of thrombocytopenia in sarcoidosis. However, in emergency situations with major bleeding, it seems reasonable to apply the current guidelines recommended for immune thrombocytopenia. The authors report a case of sarcoidosis presenting with severe thrombocytopenia, petechial rash, and nasal and gingival bleeding. LEARNING POINTS: The association of thrombocytopenia with sarcoidosis has been well described and fully documented.Immune thrombocytopenia in sarcoidosis is usually severe and symptomatic at presentation but generally has a favourable course because of modern therapeutic management.Steroids may be administered as first-line treatment for sarcoidosis, but in emergency situations with a severe bleeding risk, it seems reasonable to apply the current guidelines for immune thrombocytopenia, namely methylprednisolone (1 g/day for 2 days) and/or intravenous immunoglobulin (1 g/kg/day for 3 days).

Masson's Tumour: A Rare Cause of Cervical Mass.

Masson's tumour, also known as intravascular papillary endothelial hyperplasia, is a rare non-neoplastic lesion of vascular origin, caused by an excessive reactive proliferation of endothelial cells in normal blood vessels or vascular malformations. It can affect any part of the body, presenting most frequently in the vessels of the head, neck and upper extremities. The authors describe the case of a 76-year-old female patient presenting an anterior cervical mass, measuring 2×2 cm, which was mobile, tender and slightly painful with no alteration of the overlying skin. Complementary study with ultrasound and computed tomography was inconclusive. Total excision of the lesion was performed with histology compatible with intravascular papillary endothelial hyperplasia. LEARNING POINTS: Masson's tumour is a rare and indolent non-neoplastic lesion of vascular origin, that can be easily confused with other pathological entities and misdiagnosed.Diagnosis can be a challenge; histological characterization is essential for differentiation from other lesions, such as angiosarcoma and Kaposi's sarcoma.Masson's tumour should be considered in patients presenting a single cervical mass.