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1.
Artigo em Inglês | MEDLINE | ID: mdl-33093764

RESUMO

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely available diagnostic tool for suspected stage I/II sarcoidosis. Combination of EBUS-TBNA and transbronchial lung biopsy (TBLB) has been proposed as diagnostic procedure in clinical settings. Objectives: The aim of this study was to assess the diagnostic yield of combined EBUS-TBNA and TBLB and identify the markers correlated with a high diagnostic rate. Methods: We retrospectively analyzed the data of 37 patients with suspected stage I/II sarcoidosis with enlarged hilar or mediastinal lymph nodes on computed tomography (CT) images. These patients had been scheduled to undergo EBUS-TBNA and TBLB. Serum levels of sarcoidosis markers (angiotensin-converting enzyme [ACE], soluble interleukin-2 receptor [sIL-2R], and lysozyme), CT findings, and examination techniques were evaluated as predictive markers for diagnosis. Results: Of the 37 patients, 32 had undergone both EBUS-TBNA and TBLB, while the remaining 5 patients had only undergone EBUS-TBNA. The diagnosis was confirmed by TBLB in 16 of the 32 patients (50.0%), EBUS-TBNA in 31 of the 37 patients (83.8%), and combined TBLB and EBUS-TBNA in all patients (100.0%). The serum level of sIL-2R, but not that of ACE or lysozyme, was correlated with successful diagnosis by EBUS-TBNA. Conclusion: In patients with stage I/II sarcoidosis, the serum level of sIL-2R is a promising and useful marker for predicting the diagnosis by EBUS-TBNA and reducing the burden of additional TBLB and its possible complications. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (1): 8-16).


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Receptores de Interleucina-2/sangue , Sarcoidose Pulmonar/sangue , Sarcoidose Pulmonar/patologia , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sarcoidose Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X
2.
Artigo em Inglês | MEDLINE | ID: mdl-33093775

RESUMO

Purpose: To evaluate the Right Upper Lobe Bronchus Angle (RUL-BA) on chest CT in patients with Stage 4 sarcoidosis and compare to others with non-fibrotic sarcoidosis. Methods: IRB approval was obtained for review of all chest CT scans performed from January 2015 through December 2017 that contained the word sarcoidosis using the computer program Montage. The most recent CT scans of 633 people were reviewed. The patients' age and sex at the time of their most recent CT scan were recorded. The radiographic diagnosis and the Right Upper Lobe Bronchus Angle (RUL-BA) were determined by a chest radiologist with 20 years of experience. Results: The RUL-BA increased with Stage 4 sarcoidosis, measuring on average 104 degrees, compared to the average angle of 88 degrees for those without fibrotic sarcoid. More often men's CT scans exhibited the earlier stages of sarcoidosis, and a higher number of women's scans showed fibrotic sarcoidosis. As would be expected, scans with advanced disease were typically from older patients; however, there was no correlation between age and degree of fibrosis as measured by increasing RUL-BA. Conclusion: The RUL-BA assists radiologists in differentiating fibrotic sarcoidosis from non-fibrotic sarcoidosis. Further research will determine if the RUL-BA measurement can help differentiate fibrotic sarcoid from other fibrotic lung diseases and if the angle can be used to follow disease progression. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 99-103).


Assuntos
Brônquios/diagnóstico por imagem , Fibrose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Índice de Gravidade de Doença , Adulto Jovem
4.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(2): 35-39, jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-193752

RESUMO

INTRODUCCIÓN: La silicosis es una enfermedad generalmente de origen ocupacional. La sarcoidosis es una enfermedad multisistémica de etiología desconocida. Los patrones radiológicos de silicosis y sarcoidosis pueden ser similares. EXPOSICIÓN DEL CASO: Varón de 42 años, marmolista de profesión, diagnosticado de sarcoidosis y que presenta radiológicamente adenopatías hiliares y nódulos pulmonares en ambos lóbulos. Se declara sospecha de origen profesional de silicosis, ratificándose posteriormente por el Instituto Nacional de la Seguridad Social. DISCUSIÓN: El diagnostico de silicosis se sustenta en la concurrencia de los siguientes criterios: - Historia laboral de exposición a sílice cristalina. - Radiografía de tórax simple con profusiones > o = a 1/1 (clasificación ILO). - Exclusión de otras entidades posibles. La sarcoidosis se caracteriza patológicamente por la presencia de granulomas no caseificantes en los órganos involucrados. CONCLUSIONES: El contexto clínico y laboral de la enfermedad es crucial para poder establecer un diagnóstico correcto


INTRODUCTION: Silicosis is a disease usually of occupational origin. Sarcoidosis is a multisystemic disease of unknown etiology. The radiological patterns of silicosis and sarcoidosis can be similar. CASE STATEMENT: A 42 years old male, marbleist, diagnosed of sarcoidosis and who presents radiological hilar adenopathies and pulmonary nodules in both lobes. Suspicion of professional origin of silicosis is declared, subsequently ratified by the National Institute of Security Social. DISCUSSION: The diagnosis of silicosis is based on the concurrence of the following criteria: - Work history of exposure to crystalline silica. - Simple chest x-ray with profusions > o = 1/1 (ILO classification). - Exclusion of other possible entities. Sarcoidosis is pathologically characterized by the presence of non-caseating granulomata in the organs involved. CONCLUSIONS: The clinical and occupational context of the disease is crucial in order to establish a correct diagnosis


Assuntos
Humanos , Masculino , Adulto , Sarcoidose Pulmonar/diagnóstico por imagem , Silicose/etiologia , Silicose/diagnóstico por imagem , Dióxido de Silício/efeitos adversos , Doenças Profissionais/induzido quimicamente , Diagnóstico Diferencial , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/induzido quimicamente , Exposição Ocupacional , Tomografia Computadorizada por Raios X
5.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(2): 35-39, jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-ET5-1967

RESUMO

INTRODUCCIÓN: La silicosis es una enfermedad generalmente de origen ocupacional. La sarcoidosis es una enfermedad multisistémica de etiología desconocida. Los patrones radiológicos de silicosis y sarcoidosis pueden ser similares. EXPOSICIÓN DEL CASO: Varón de 42 años, marmolista de profesión, diagnosticado de sarcoidosis y que presenta radiológicamente adenopatías hiliares y nódulos pulmonares en ambos lóbulos. Se declara sospecha de origen profesional de silicosis, ratificándose posteriormente por el Instituto Nacional de la Seguridad Social. DISCUSIÓN: El diagnostico de silicosis se sustenta en la concurrencia de los siguientes criterios: - Historia laboral de exposición a sílice cristalina. - Radiografía de tórax simple con profusiones > o = a 1/1 (clasificación ILO). - Exclusión de otras entidades posibles. La sarcoidosis se caracteriza patológicamente por la presencia de granulomas no caseificantes en los órganos involucrados. CONCLUSIONES: El contexto clínico y laboral de la enfermedad es crucial para poder establecer un diagnóstico correcto


INTRODUCTION: Silicosis is a disease usually of occupational origin. Sarcoidosis is a multisystemic disease of unknown etiology. The radiological patterns of silicosis and sarcoidosis can be similar. CASE STATEMENT: A 42 years old male, marbleist, diagnosed of sarcoidosis and who presents radiological hilar adenopathies and pulmonary nodules in both lobes. Suspicion of professional origin of silicosis is declared, subsequently ratified by the National Institute of Security Social. DISCUSSION: The diagnosis of silicosis is based on the concurrence of the following criteria: - Work history of exposure to crystalline silica. - Simple chest x-ray with profusions > o = 1/1 (ILO classification). - Exclusion of other possible entities. Sarcoidosis is pathologically characterized by the presence of non-caseating granulomata in the organs involved. CONCLUSIONS: The clinical and occupational context of the disease is crucial in order to establish a correct diagnosis


Assuntos
Humanos , Masculino , Adulto , Sarcoidose Pulmonar/diagnóstico por imagem , Silicose/etiologia , Silicose/diagnóstico por imagem , Dióxido de Silício/efeitos adversos , Doenças Profissionais/induzido quimicamente , Diagnóstico Diferencial , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/induzido quimicamente , Exposição Ocupacional , Tomografia Computadorizada por Raios X
6.
Int J Cardiovasc Imaging ; 36(8): 1497-1505, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32350704

RESUMO

Pulmonary hypertension (PH) is a well-recognised complication of sarcoidosis. Non-invasive diagnosis is challenging due to limited accuracy of echocardiography in interstitial lung disease. This study evaluates the value of echocardiographic PH probability for diagnosing PH in pulmonary sarcoidosis. All consecutive patients between August 2015 and November 2018 were prospectively screened for PH, and classified as low, intermediate or high PH probability. Patients with intermediate or high PH probability were referred for right heart catheterisation. PH was defined as a mean pulmonary artery pressure of ≥ 25 mm Hg. Additional data on pulmonary function and chest-CT was collected. Of all 479 patients, PH was present in 17 and absent in 19 patients. Six patients refused right heart catheterisation. PH was present in 33% and 75% of patients with intermediate and high PH probability respectively (n = 36). TRV max was measurable in 46% of all patients. Measurability did not correlate with FVC% predicted or presence of significant fibrosis. In intermediate and high PH probability, TRV max < 2.9 m/s successfully ruled out PH whereas a TRV max > 3.4 confirmed PH in all patients. If TRV max was absent or in between 2.9 and 3.4, secondary echocardiographic signs were not able to improve the diagnostic accuracy. PH is unlikely in patients with a TRV max < 2.9 m/s on echocardiography, whereas PH is highly suspected in a TRV max > 3.4 m/s. Discrimination is challenging if the TRV max is between 2.9-3.4 m/s or absent. Additional secondary signs do not improve discrimination. Decision making for further investigations should be made by an expert team.


Assuntos
Ecocardiografia , Hipertensão Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/diagnóstico por imagem , Adulto , Idoso , Pressão Arterial , Função do Átrio Direito , Progressão da Doença , Feminino , Humanos , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/fisiopatologia , Fatores de Risco , Sarcoidose Pulmonar/complicações , Sarcoidose Pulmonar/fisiopatologia , Função Ventricular Direita
7.
Respir Investig ; 58(4): 232-238, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32305227

RESUMO

Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology. Diagnosis of sarcoidosis is made by correlating clinical and radiological features along with the histopathological demonstration of non-necrotizing granulomas in tissue samples. Diagnosis is often challenging as the clinical profile may mimic other granulomatous disorders, including infections, inflammatory diseases, and lymphoid malignancies. Differentiation from tuberculosis is especially crucial in endemic regions where exclusion of mediastinal tuberculosis is necessary before any immunosuppressant treatment can be initiated for symptomatic sarcoidosis. Identification of biomarkers, which can aid in diagnosis as well as prognosis, can be helpful in clinical decision making. MicroRNAs are small non-coding regulatory RNAs that serve as post-transcriptional regulators of gene expression and have been studied as emerging biomarkers in many other respiratory diseases, including lung cancer, asthma, idiopathic pulmonary fibrosis, and chronic obstructive pulmonary disease. In the context of sarcoidosis, miRNA expression has been studied in the lungs, lymph nodes, bronchoalveolar lavage fluid, and peripheral blood mononuclear cells. A comprehensive search of the PubMed database was performed by two authors independently, and relevant studies were retrieved for review. This systematic review summarizes the current information on miRNAs in sarcoidosis, the biological mechanisms involved in CD4+ T-helper 1 and macrophage polarization, and the use of exhaled breath condensate as an alternative, noninvasive and potential source of miRNAs.


Assuntos
MicroRNAs/análise , Sarcoidose Pulmonar/diagnóstico por imagem , Biomarcadores/análise , Testes Respiratórios , Líquido da Lavagem Broncoalveolar , Linfócitos T CD4-Positivos , Diagnóstico Diferencial , Expressão Gênica , Humanos , Leucócitos Mononucleares , Pulmão/metabolismo , Linfonodos/metabolismo , Macrófagos , MicroRNAs/genética , Linfócitos T Auxiliares-Indutores
13.
AJR Am J Roentgenol ; 214(1): 50-58, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31670585

RESUMO

OBJECTIVE. This article will review the typical and atypical imaging features of sarcoidosis, identify entities that may be mistaken for sarcoidosis, and discuss patterns and clinical scenarios that suggest an alternative diagnosis. CONCLUSION. Radiologists must be familiar with the characteristic findings in sarcoidosis and be attentive to situations that suggest alternative diagnoses. The radiologist plays a major role in prompt diagnosis and one that may help reduce patient morbidity and mortality.


Assuntos
Sarcoidose Pulmonar/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Radiologia , Tomografia Computadorizada por Raios X
14.
J Investig Med High Impact Case Rep ; 7: 2324709619892724, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808363

RESUMO

This is a rare case of sarcoidosis-like granulomatous lymphadenopathy that was initially mistaken for a neoplastic process due to the degree of hypermetabolic changes observed on positron emission tomography (PET) scan. Sarcoid-like granulomatous pulmonary disease is a disorder that has been described in WTC (World Trade Center) Rescue Workers, and also known as post 9/11 sarcoidosis. We present an interesting case of a man who presented with several months of progressive dyspnea and was later discovered to have significant bilateral hilar adenopathy, which was PET avid. Even more interesting, this patient's symptoms completely resolved without the use of systemic steroids or immune suppressants. This is a condition that requires awareness in order to avoid repeating unnecessary tests of performing interventions on a benign condition that may resolve on its own.


Assuntos
Granuloma/diagnóstico por imagem , Linfadenopatia/diagnóstico por imagem , Trabalho de Resgate , Sarcoidose Pulmonar/diagnóstico por imagem , Tolerância a Antígenos Próprios , Diagnóstico Diferencial , Dispneia/etiologia , Granuloma/complicações , Humanos , Linfadenopatia/complicações , Masculino , Pessoa de Meia-Idade , Sarcoidose Pulmonar/complicações , Ataques Terroristas de 11 de Setembro , Procedimentos Desnecessários
15.
Rev. patol. respir ; 22(4): 181-183, oct.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-189009

RESUMO

Varón de 53 años, exfumador, diagnosticado de EPOC y sarcoidosis sistémica en tratamiento (afectación ganglionar múltiple, cutánea y renal) que presentó un infiltrado parenquimatoso en lóbulo superior izquierdo como hallazgo casual en radiografía de tórax. En TC realizada dada su persistencia, se observó afectación en vidrio deslustrado en campos medios y superiores, aparentemente secundaria a sarcoidosis. Dado el contexto de estabilidad clínica, se decidió realizar un control radiográfico en 6 meses, objetivándose un claro empeoramiento. La nueva TC mostró zonas de consolidación sobre las áreas que previamente presentaban mayor afectación en vidrio deslustrado, mostrando ahora valores de atenuación tan elevados que únicamente podrían corresponder a calcio. La aparición de las calcificaciones sobre tejido pulmonar previamente alterado, así como la ausencia de datos clínicos y analíticos de infección y/o desestabilización del metabolismo del calcio, apoyan que la sarcoidosis sea la causa de estas calcificaciones, lo cual es excepcional


53-year-old man, former smoker, with COPD and systemic sarcoidosis under treatment (multiple lymph nodes, skin and kidney affection). A chest x-ray showed a parenchyma infiltrate in upper left lobe. Chest CT demonstrated areas of ground-glass opacification at middle and upper areas of both lungs. As the patient was clinically stable, we decided to do an X-ray control 6 months later. The new chest X-ray image showed a clear worsening, with more severe infiltrates in middle and upper areas of both lungs. At this time, chest CT demonstrated pulmonary calcifications at the same areas that had been shown affected in the previous CT. These dystrophic calcifications were probably secondary to sarcoidosis. This is further supported by the clinical and analytical stability of the patient during this period, without developing signs of infectious processes or decompensation of calcium metabolic disorders


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Sarcoidose Pulmonar/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Pulmão/patologia , Tomografia Computadorizada por Raios X
16.
Reumatol. clín. (Barc.) ; 15(6): e133-e135, nov.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-189673

RESUMO

La sarcoidosis y la tuberculosis son 2 enfermedades granulomatosas frecuentes que comparten presentaciones clínicas y radiológicas. Entre los signos radiológicos característicos de sarcoidosis pulmonar descritos recientemente en la tomografía computarizada de tórax destaca el signo de la «galaxia». Presentamos un caso de sarcoidosis que inicialmente fue confundido con una tuberculosis en el que este signo radiológico fue útil para indicar el diagnóstico correcto


Sarcoidosis and tuberculosis are two common granulomatous conditions that may share clinical and radiological presentations. The galaxy sign (sarcoid galaxy sign) is a characteristic radiological sign of pulmonary sarcoidosis on thoracic computed tomography (CT). We present the case of a patient with sarcoidosis that was initially misdiagnosed as tuberculosis, in whom the galaxy sign on CT was useful as it suggested the correct diagnosis


Assuntos
Humanos , Feminino , Adulto , Sarcoidose Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico por imagem , Diagnóstico Diferencial
18.
Reumatol. clín. (Barc.) ; 15(5): e18-e20, sept.-oct. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-189413

RESUMO

Sarcoidosis is a chronic, inflammatory disease with unknown cause characterized by non-caseating granuloma formations. It can be presented with bilateral hilar lymphadenopathy, skin lesions, eye involvement and locomotor system findings. Adult onset Still disease (AOSD) is a chronic inflammatory disease which presents with fever, arthritis and typical skin rashes. The disease is rare and can be misdiagnosed due to the absence of typical clinical and laboratory findings. The association of sarcoidosis and AOSD has not been previously reported in the literature. Herein we reported the development of AOSD in a patient followed by the diagnosis of sarcoidosis. The patient did not respond to high-dose corticosteroids and methotrexate therapy, and the disease was under control with anti-IL-6 (Tocilizumab) drug


La sarcoidosis es una enfermedad inflamatoria crónica de causa desconocida, que se caracteriza por formaciones de granulomas no caseificantes. Puede presentarse como linfadenopatía hiliar bilateral, lesiones cutáneas, compromiso ocular y del sistema locomotor. La enfermedad de Still del adulto (AOSD) es una enfermedad inflamatoria crónica que se presenta con fiebre, artritis y erupciones cutáneas típicas. Dicha enfermedad es rara y puede diagnoticarse erróneamente debido a la ausencia de rasgos clínicos y de laboratorio típicos. En la literatura no se ha reportado previamente la asociación entre sarcoidosis y AOSD. Reportamos aquí el desarrollo de AOSD en un paciente sometido a seguimiento debido a diagnóstico de sarcoidosis. El paciente no respondió al tratamiento con altas dosis de corticosteroides y metotrexato, manteniéndose la enfermedad bajo control con un fármaco anti-IL-6 (Tocilizumab)


Assuntos
Humanos , Masculino , Adulto Jovem , Sarcoidose Pulmonar/complicações , Doença de Still de Início Tardio/complicações , Anticorpos Monoclonais Humanizados/uso terapêutico , Imunossupressores/uso terapêutico , Metotrexato/uso terapêutico , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/tratamento farmacológico , Doença de Still de Início Tardio/tratamento farmacológico , Tomografia Computadorizada por Raios X
19.
Radiol Technol ; 91(1): 27-47, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31471476

RESUMO

Lung transplantation can prolong and improve quality of life for patients affected by end-stage lung disease. Potential lung transplant patients undergo a rigorous preoperative assessment that includes multiple medical imaging studies. These studies provide information that help physicians determine whether the patient is a surgical candidate, as well as the surgical technique that should be used during transplantation. Imaging studies also are used in long-term care to detect complications in patients after lung transplantation.


Assuntos
Transplante de Pulmão , Seleção de Pacientes , Transplantados , Contraindicações de Procedimentos , Fibrose Cística/diagnóstico por imagem , Fibrose Cística/cirurgia , Humanos , Fibrose Pulmonar Idiopática/diagnóstico por imagem , Fibrose Pulmonar Idiopática/cirurgia , Complicações Pós-Operatórias , Cuidados Pré-Operatórios , Hipertensão Arterial Pulmonar/diagnóstico por imagem , Hipertensão Arterial Pulmonar/cirurgia , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Doença Pulmonar Obstrutiva Crônica/cirurgia , Enfisema Pulmonar/diagnóstico por imagem , Enfisema Pulmonar/etiologia , Enfisema Pulmonar/cirurgia , Encaminhamento e Consulta , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/cirurgia , Sociedades Médicas , Taxa de Sobrevida , Tomografia Computadorizada por Raios X , Listas de Espera , Deficiência de alfa 1-Antitripsina/complicações
20.
Arch. Soc. Esp. Oftalmol ; 94(9): 453-459, sept. 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-186226

RESUMO

Se presenta un caso raro de una mujer caucásica de 29 años con un granuloma en una cicatriz antigua, en la región periocular derecha, como primer signo clínico de una sarcoidosis sistémica. Se procedió a una biopsia escisional de la lesión con diagnóstico anatomopatológico de inflamación crónica granulomatosa no necrosante, con características histológicas sugestivas de sarcoidosis de cicatriz. Al año, la lesión recidivó, por lo que se trató con esteroides depot intralesionales. Esta patología se produce con más frecuencia cuando existen cuerpos extraños y puede ser la primera señal de sarcoidosis sistémica


An unusual case is presented of a 29 year-old Caucasian woman with a granuloma in an old scar in the right periocular region as a first clinical sign of a systemic sarcoidosis. An excisional biopsy was performed, for which the histological diagnosis was a chronic non-necrotising granulomatous inflammation, suggestive of scar sarcoidosis. The lesion re-appeared one year after initial treatment, and was treated with intralesional depot steroids, showing adequate progression. This disease occurs more frequently in wound areas where there are foreign bodies and could be the first sign of systemic sarcoidosis


Assuntos
Humanos , Feminino , Adulto , Cicatriz/patologia , Dermatoses Faciais/diagnóstico , Granuloma de Corpo Estranho/patologia , Sarcoidose/diagnóstico , Anti-Inflamatórios/uso terapêutico , Biópsia , Dermatoses Faciais/diagnóstico por imagem , Dermatoses Faciais/patologia , Traumatismos Faciais/complicações , Traumatismos Faciais/patologia , Granuloma de Corpo Estranho/diagnóstico por imagem , Granuloma de Corpo Estranho/etiologia , Imagem por Ressonância Magnética , Recidiva , Sarcoidose/tratamento farmacológico , Sarcoidose/patologia , Sarcoidose Pulmonar/complicações , Sarcoidose Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Triancinolona Acetonida/uso terapêutico , Cicatrização
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