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2.
Einstein (Sao Paulo) ; 17(4): eMD5157, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826074

RESUMO

Elastography is a widely used procedure in conventional ultrasonography that has recently been incorporated in echoendoscopy. This is an innovative and promising technology that aims to increase the negative predictive value of endoscopic ultrasonography and fine-needle aspiration punctures. It is useful for directing punctures in suspect areas and, consequently, improves diagnostic performance. This is a non-invasive technique, easy to perform, without additional costs or complications. The main indications are the analysis of solid pancreatic masses, lymph nodes, subepithelial lesions, lesions in the left hepatic lobe and in the left adrenal. Negative or inconclusive cases of fine-needle aspiration can be submitted to elastography when there is a strong suspicion of malignancy. Elastography has a high precision for the differential diagnosis of solid masses and in difficult-to-access anatomic sites, as well as in mediastinal lymph nodes and pancreatic tumors. The procedure is based on the degree of tissue elasticity measurement, with a good correlation between the elasticity index and histopathological features. We report the case of four patients evaluated by echoendoscopy and qualitative elastography who had differential diagnoses in mediastinal lymph nodes: sarcoidosis, lymphoma, histoplasmosis and esophageal neoplasia.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Endossonografia/métodos , Linfonodos/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Adulto , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
4.
Pan Afr Med J ; 33: 250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692793

RESUMO

Sarcoidosis is a non-caseating inflammatory chronic systemic disease of unknown etiology, which may affect one or more organs. Paranasal sinuses involvement occurs sporadic in sarcoidosis. We report a patient with a medical history of sarcoidosis involving her lungs, liver, and lymphatic system for four years who now presented with nasal and sinuses symptoms. The primary treatment with local cortisone showed no improvement. Computed tomography (CT) scan of the paranasal sinuses (PNS) revealed signs of chronic pansinusitis. She was successfully treated with endoscopic sinonasal surgery. Subsequent histological analysis confirmed the involvement of the PNS with sarcoidosis. Her follow-up during the last 6 months was without recurrence.


Assuntos
Doenças dos Seios Paranasais/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Sinusite/diagnóstico por imagem , Adulto , Doença Crônica , Endoscopia/métodos , Feminino , Seguimentos , Humanos , Doenças dos Seios Paranasais/cirurgia , Sarcoidose/cirurgia , Tomografia Computadorizada por Raios X
5.
Clin Nucl Med ; 44(11): 905-906, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31584495

RESUMO

We report a case of a 50-year-old woman treated with anti-PD-1 inhibition for metastatic melanoma. During treatment, extensive and transient histopathologically confirmed sarcoid-like reaction was detected in multiple organ systems and at different time points using F-FDG PET/CT imaging. Immune-related adverse events during anti-PD-1/PD-L1 antibody treatment are increasingly being reported. This case report emphasizes the broad spectrum of possible presentations of sarcoid-like reaction detected by F-FDG PET/CT and its evolution in time. For the clinician, awareness of these immune-related adverse events helps to accurately interpret findings on imaging.


Assuntos
Anticorpos/efeitos adversos , Fluordesoxiglucose F18 , Melanoma/terapia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Receptor de Morte Celular Programada 1/imunologia , Sarcoidose/diagnóstico por imagem , Sarcoidose/etiologia , Anticorpos/imunologia , Anticorpos/uso terapêutico , Feminino , Humanos , Melanoma/patologia , Pessoa de Meia-Idade , Metástase Neoplásica
6.
Spine (Phila Pa 1976) ; 44(21): E1248-E1255, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31634300

RESUMO

STUDY DESIGN: A case series of dual time-point F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F-FDG PET/CT) for the diagnosis of spinal cord sarcoidosis. OBJECTIVE: The aim of this study was to illustrate three cases of spinal sarcoidosis with occult presentation and subsequent identification with the use of dual time-point F-FDG PET/CT. SUMMARY OF BACKGROUND DATA: Sarcoidosis of the spinal cord is very rare and when it occurs without systemic manifestations of disease can be a challenging diagnostic dilemma frequently resulting in the need for spinal cord biopsy in order to establish a diagnosis. METHODS: Case series presentation and report. RESULTS: This manuscript presents a case series experience of dual time-point F-FDG PET/CT for the diagnosis of spinal cord sarcoidosis. We review the cases of three patients who presented with myelopathy and underwent F-FDG DTPI as part of the evaluation for enhancing spinal cord lesions of unknown etiology for 2 years at a university-based cancer hospital. F-FDG DTPI was vital in making the diagnosis of sarcoidosis, and in two of the cases, the patients were able to avoid biopsy, thereby avoiding potential morbidity from an invasive procedure. CONCLUSION: F-FDG PET/CT imaging is a noninvasive imaging technique that can be crucial in the diagnosis of sarcoidosis of the spinal cord and help avoid unnecessary procedures. LEVEL OF EVIDENCE: 4.


Assuntos
Fluordesoxiglucose F18 , Compostos Radiofarmacêuticos , Sarcoidose/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Sarcoidose/patologia , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/patologia , Doenças da Coluna Vertebral/patologia
8.
BMJ Case Rep ; 12(9)2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31527203

RESUMO

Sarcoidosis is a multisystem disorder characterised by non-caseating granulomas that typically affect the lungs, skin and lymph nodes. Sarcoidosis has been associated with various cancers, and we describe the case of a patient with systemic sarcoidosis associated with testicular seminoma. This was originally diagnosed as stable sarcoid-like reaction. He subsequently presented with ventricular tachycardia. Cardiovascular MRI suggested cardiac sarcoidosis, which was confirmed by myocardial biopsy. This case highlights the association between some types of cancer and sarcoidosis. In addition, it highlights the importance of close follow-up for patients with a history of malignancy to monitor for sarcoid-like reactions and sarcoidosis, which are often difficult to differentiate clinically.


Assuntos
Cardiopatias/etiologia , Sarcoidose/etiologia , Seminoma/complicações , Neoplasias Testiculares/complicações , Adulto , Desfibriladores Implantáveis , Diagnóstico Diferencial , Cardiopatias/diagnóstico por imagem , Humanos , Letargia , Masculino , Sarcoidose/diagnóstico por imagem , Seminoma/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Vômito
9.
Ear Nose Throat J ; 98(8): NP120-NP124, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31522556

RESUMO

OBJECTIVES: To describe a unique case of isolated bilateral sarcoidosis of the cerebellopontine angle as well as the related imaging in the case. To conduct a literature review of the published articles regarding sarcoidosis of the cerebellopontine angle. DATA SOURCES: Representative case report from a single institution as well as PubMed and Scopus database searches. METHODS: In addition to a retrospective review, all published case reports and case series of sarcoidosis involving the cerebellopontine angle from 1960 to July 2018 in the English language were reviewed. Demographic data, presenting symptoms, and outcomes were collected. RESULTS: We identified 8 total cases with pertinent clinical information that were included. CONCLUSIONS: Isolated neurosarcoidosis of the cerebellopontine angle is an exceptionally rare phenomenon that, on history and imaging, presents similar to more common retrocochlear pathologies. Surgery may be required in large lesions unresponsive to traditional medical therapy with immunosuppression.


Assuntos
Doenças do Sistema Nervoso Central/diagnóstico por imagem , Doenças do Sistema Nervoso Central/patologia , Neuroma Acústico/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Sarcoidose/patologia , Doenças do Sistema Nervoso Central/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Sarcoidose/cirurgia
10.
Clin Nucl Med ; 44(10): 824-825, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31274562

RESUMO

A 43-year-old woman, with previous history of renal lithiasis, was admitted on an emergency for severe hypercalcemia fortuitously discovered in a context of rapidly progressive kidney failure. An F-FDG PET/CT performed to rule out underlying malignancy revealed an intense diffuse and isolated muscular FDG uptake with fascia infiltration on the CT finding. A muscular biopsy was performed and demonstrated a non-necrosing granuloma with multinucleated giant cells consistent with muscular sarcoidosis. A corticotherapy was started with a rapid normalization of serum calcium level. The follow-up F-FDG PET/CT 4 months later showed a complete response of the sarcoidosis myositis.


Assuntos
Fluordesoxiglucose F18 , Hipercalcemia/complicações , Músculos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Adulto , Biópsia , Feminino , Humanos , Músculos/patologia , Sarcoidose/patologia
11.
Clin Nucl Med ; 44(8): 646-647, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274611

RESUMO

We report the case of a 62-year-old woman with previous history of stage III Hodgkin lymphoma. Routine follow-up CT scan revealed 2 years after end of treatment the appearance of mediastinal nodes, suspected of lymphoma recurrence. An F-FDG PET/CT was performed showing hypermetabolic mediastinal lymph nodes with diffuse symmetric osteomedullar hypermetabolism of pelvis and scapulae. In the hypothesis of either recurrence or multisystemic inflammatory disorder, bone marrow and lymph node biopsies were performed, revealing the presence of noncaseating epithelioid cell granulomas, leading to the diagnosis of multisystemic sarcoidosis. This case illustrates the sarcoidosis-lymphoma syndrome.


Assuntos
Doença de Hodgkin/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Biópsia , Feminino , Fluordesoxiglucose F18 , Doença de Hodgkin/patologia , Humanos , Pessoa de Meia-Idade , Recidiva , Sarcoidose/patologia
12.
Clin Nucl Med ; 44(9): e519-e521, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31348077

RESUMO

A 57-year-old man with stage IIIB malignant melanoma of unknown primary presented for pretherapy FDG PET/CT that demonstrated metastatic left cervical lymph node with no other site of involvement. Following left neck dissection, nivolumab was initiated. Follow-up FDG PET/CT 3 months after initiation of nivolumab demonstrated extensive radiotracer-avid chest lymphadenopathy and multiple bone lesions. Ultrasound-guided endobronchial biopsy of the mediastinal lymph nodes demonstrated sarcoidosis.


Assuntos
Doenças Ósseas/induzido quimicamente , Pneumopatias/induzido quimicamente , Melanoma/tratamento farmacológico , Neoplasias Primárias Desconhecidas/tratamento farmacológico , Nivolumabe/efeitos adversos , Sarcoidose/induzido quimicamente , Sarcoidose/diagnóstico por imagem , Doenças Ósseas/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Pneumopatias/diagnóstico por imagem , Linfadenopatia/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Nivolumabe/uso terapêutico , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
13.
Medicine (Baltimore) ; 98(24): e16001, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192941

RESUMO

RATIONALE: Sarcoidosis is an idiopathic granulomatous disease. Although the lungs are most commonly involved, any organ may be affected. To assist with future diagnoses, we describe a rare case of peritoneal sarcoidosis in a young female patient, and present a literature review. PATIENT CONCERNS: A 32-year-old female patient presented to our institution with abdominal discomfort. She was evaluated with contrast-enhanced abdominal computed tomography (CT), and multiple enlarged lymph nodes were detected at the hepatic artery and left gastric artery nodal stations. The patient was lost during follow-up, but returned after 7 months and again underwent abdominal CT. This revealed diffuse nodular thickening of the peritoneum and the appearance of omental cake in her abdomen. DIAGNOSIS: Excisional biopsy of a lymph node was performed and extrapulmonary sarcoidosis was confirmed. INTERVENTIONS: The patient was treated with corticosteroid. OUTCOMES: A follow-up abdominal CT scan after two weeks revealed decreases in the numbers and sizes of the previously enlarged lymph nodes, and improvement in the ascites and peritoneal thickening. LESSIONS: Peritoneal sarcoidosis should be considered as an additional differential diagnosis when peritoneal carcinomatosis or tuberculous peritonitis are suspected. In this regard, serum levels of angiotensin-converting enzyme (ACE) may be a valuable diagnostic indicator of unusual sarcoidosis presentations.


Assuntos
Linfonodos/cirurgia , Doenças Peritoneais/diagnóstico por imagem , Sarcoidose/diagnóstico por imagem , Corticosteroides/uso terapêutico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Doenças Peritoneais/tratamento farmacológico , Doenças Peritoneais/patologia , Sarcoidose/tratamento farmacológico , Sarcoidose/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
14.
Br J Radiol ; 92(1100): 20190247, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31166768

RESUMO

The myocardium and the cardiovascular system are often involved in patients with sarcoidosis. As therapy should be started as early as possible to avoid complications such as left ventricular dysfunction, a prompt and reliable diagnosis by means of non-invasive tests would be highly warranted. Among other techniques, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has emerged as a high sensitive tool to detect sites of inflammation before morphological changes are visible to conventional imaging techniques. We therefore aim at summarizing the most relevant findings in the literature on the use of 18F-fluorodeoxyglucose PET in the diagnostic workup of cardiac sarcoidosis and to underline future perspectives.


Assuntos
Cardiomiopatias/diagnóstico por imagem , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Sarcoidose/diagnóstico por imagem , Coração/diagnóstico por imagem , Humanos
15.
Indian J Tuberc ; 66(2): 314-317, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31151503

RESUMO

Tuberculosis and sarcoidosis are chronic multisystem granulomatous conditions which have different aetiology and management but may mimic each other clinically, radiologically and pathologically. Both these diseases usually have a sub acute or chronic presentation and it is rather uncommon for them to coexist or present with acute respiratory failure. We report a case of a 57-year-old male who presented with pyrexia of unknown origin with chronic cough. He was initially diagnosed to have sarcoidosis based on clinico-radiological and histologic evidence and was started on corticosteroids. However, he presented within two weeks with acute respiratory distress and on further investigation was diagnosed with co-existing pulmonary tuberculosis.


Assuntos
Síndrome do Desconforto Respiratório do Adulto/diagnóstico , Sarcoidose/diagnóstico , Tuberculose Pulmonar/diagnóstico , Tosse/etiologia , Diagnóstico Diferencial , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório do Adulto/complicações , Síndrome do Desconforto Respiratório do Adulto/diagnóstico por imagem , Sarcoidose/complicações , Sarcoidose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico por imagem
16.
Acta Reumatol Port ; 44(1): 42-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31249275

RESUMO

In the second part of this review article we will describe the imaging features of non- spondyloarthritis (SpA) pathologies that may mimic sacroiliitis on Magnetic Resonance Imaging (MRI), and that readers should be aware (part 2). Based on the established literature, there is currently an "overcall" of sacroiliitis on MRIs. In this setting, differential diagnoses and their imaging features come into play. In fact, non-SpA related sacroiliac joints (SIJs) pathologies are more commonly found than true sacroiliitis on MRI of the SIJs, even in patients with inflammatory type back pain. An imaging literature review, highlighting "easy-to-use" learning points regarding MRI interpretations in patients with suspected sacroiliitis and/or nonspecific lumbar back pain is presented. This two-part article aims to be a snapshot of the most common inflammatory versus non-inflammatory entities found on SIJs imaging studies in routine practice, while trying to keep this review article simple, educational and above all, practical.


Assuntos
Imagem por Ressonância Magnética , Articulação Sacroilíaca/diagnóstico por imagem , Sacroileíte/diagnóstico por imagem , Espondilartrite/diagnóstico por imagem , Síndrome de Hiperostose Adquirida/diagnóstico por imagem , Adulto , Neoplasias Ósseas/diagnóstico por imagem , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Fraturas de Estresse/diagnóstico por imagem , Gota/diagnóstico por imagem , Humanos , Hiperostose Esquelética Difusa Idiopática/diagnóstico por imagem , Hipertireoidismo/complicações , Dor Lombar/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteíte/diagnóstico por imagem , Osteíte Deformante/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Articulação Sacroilíaca/anatomia & histologia , Sarcoidose/diagnóstico por imagem
17.
Rev. argent. radiol ; 83(2): 77-86, jun. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1020470

RESUMO

La sarcoidosis es una enfermedad granulomatosa no caseificante, multisistémica, de causa desconocida, que compromete al pulmón y a los ganglios linfáticos mediastinales entre el 90 y el 95% de los casos. También puede afectar otros órganos, como las glándulas salivales, piel, ojos, hígado, bazo, corazón, huesos y sistema nervioso central. La sarcoidosis tiene una baja prevalencia en Latinoamérica y es subdiagnosticada debido a la alta frecuencia de otros trastornos similares, como tuberculosis, lepra y micosis profundas. El diagnóstico presuntivo se establece con hallazgos imagenológicos característicos dentro de un contexto clínico apropiado y se confirma con la evidencia histológica de granulomas no caseificantes de células epiteliales, en ausencia de otras etiologías. Los hallazgos torácicos incluyen la afectación pulmonar, ganglionar y bronquial, los cuales son detectados a través de la radiografía (Rx) y tomografía computada (TC) de tórax, siendo esa última más sensible y específica. En este artículo, resaltamos la importancia de reconocer los patrones de presentación típicos y atípicos de la sarcoidosis en Rx y TC, así como la relevancia de las imágenes torácicas como elemento clave en el algoritmo diagnóstico de esa patología. También describimos la utilidad de la resonancia magnética (RM), como método adicional para el diagnóstico en casos de afectación cardíaca y el papel de la tomografía por emisión de positrones (PET-CT) en el seguimiento terapéutico.


Sarcoidosis is a non-caseating granulomatous, multisystemic disease of unknown cause that involves the lung and mediastinal lymph nodes in 90-95% of cases. It can also affect other organs such as the salivary glands, skin, eyes, liver, spleen, heart, bones and the central nervous system. Sarcoidosis has a low prevalence in Latin America and it is underdiagnosed due to the high frequency of other similar disorders such as tuberculosis, leprosy and deep mycosis. The presumptive diagnosis is established based on characteristic imaging findings within an appropriate clinical setting and is confirmed by histological evidence of non-caseating epithelioid cell granulomas, in the absence of other etiologies. Thoracic imaging findings include pulmonary, nodal and bronchial involvement, which are detected on chest radiography (CXR) and computed tomography (CT), this last one having a higher sensitivity and specificity. In this article, we highlight the importance of recognizing the typical and atypical presentation patterns of sarcoidosis on CXR and CT, as well as the relevance of thoracic images as key elements in the diagnostic algorithm of this pathology. We also describe the usefulness of magnetic resonance (MR) imaging as an additional method for diagnosis in cases of cardiac involvement and the role of positron emission tomography (PET-CT) in therapeutic follow-up.


Assuntos
Humanos , Sarcoidose , Sarcoidose/diagnóstico por imagem , Espectroscopia de Ressonância Magnética/métodos , Radiografia/métodos , Tomografia Computadorizada por Raios X/métodos , Sarcoidose Pulmonar/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Sarcoidose/diagnóstico , Radiografia Torácica
19.
Medicine (Baltimore) ; 98(21): e15779, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124970

RESUMO

To assess characteristics and outcomes of patients hospitalized with interstitial lung diseases (ILD) and to analyze patient's comorbidities, procedures, and in-hospital outcomes.We identified patients hospitalized with idiopathic pulmonary fibrosis and others ILD such as hypersensitivity pneumonitis, cryptogenic organizing pneumonia, lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, and sarcoidosis in Spain during 2014 and 2015.We identified 14,565 discharges among patients admitted for ILD in Spain during the study period: idiopathic pulmonary fibrosis (IPF) in 42.32% (n = 6164), sarcoidosis in 37.65% (n = 5484), hypersensitivity pneumonitis in 10.55% (n = 1538), cryptogenic organizing pneumonia in 7.06% (n = 1028), pulmonary Langerhans cell histiocytosis in 1.48% (n = 215), and lymphangioleiomyomatosis in 0.94% (n = 136). The most common associated comorbidities according to those included in the Charlson Comorbidity Index (CCI) were COPD, diabetes, and congestive heart disease. The presence of pulmonary hypertension increased the probability of dying in patients with idiopathic pulmonary fibrosis (OR 1.36; 95%CI 1.06-1.73). Patients with cryptogenic organizing pneumonia had the longest length of hospital stay and the highest percentage of hospital readmissions (23.64%). The highest IHM corresponded to the idiopathic pulmonary fibrosis (14.94%). Computed tomography of the chest was the procedure more used during admissions for ILD.IPF was responsible for larger percentage of hospital admission among ILD in our study. In addition, the IHM were higher in IPF patients in comparison with those with other ILD. The most common associated comorbidity in ILD according to those included in the CCI was COPD. Computed tomography of the chest was the procedure more frequently used.


Assuntos
Diabetes Mellitus/epidemiologia , Insuficiência Cardíaca/epidemiologia , Hospitalização/estatística & dados numéricos , Doenças Pulmonares Intersticiais/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alveolite Alérgica Extrínseca/diagnóstico por imagem , Alveolite Alérgica Extrínseca/epidemiologia , Criança , Comorbidade , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pneumonia em Organização Criptogênica/epidemiologia , Feminino , Histiocitose de Células de Langerhans/diagnóstico por imagem , Histiocitose de Células de Langerhans/epidemiologia , Mortalidade Hospitalar , Humanos , Fibrose Pulmonar Idiopática/diagnóstico por imagem , Fibrose Pulmonar Idiopática/epidemiologia , Pulmão/diagnóstico por imagem , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoidose/diagnóstico por imagem , Sarcoidose/epidemiologia , Espanha/epidemiologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adulto Jovem
20.
Oncol Res Treat ; 42(7-8): 382-386, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31137029

RESUMO

BACKGROUND: The association of sarcoid-like lesions and malignancy is well described. Nonetheless, pulmonary lesions in malignant disease are typically presumed metastatic, and do not routinely receive histological validation. Here, we report on pulmonary sarcoid-like lesions identified in patients with a primary malignancy where pulmonary metastatic disease was suspected. METHODS: Patients who underwent thoracic surgical procedures for confirmation or treatment of suspected pulmonary metastasis were retrospectively analysed. RESULTS: In 8/186 patients (4.3%), histology revealed sarcoid-like lesions. In these cases, there were no clinical symptoms suggestive of sarcoidosis. All underlying primary malignancies in the sarcoid-like patients were treated with curative intent. The median age of patients with sarcoid-like lesions was 46.3 years (range 26-61). The median interval between primary diagnosis of malignancy and diagnosis of pulmonary lesions was 188 days (range 0-794), with thoracic surgical intervention performed at a median of 250 days (range 183-675). FDG-avidity was demonstrated in the sarcoid-like lesions in 2 out of 3 patients who underwent PET-CT. CONCLUSION: Sarcoid-like lesions may be challenging to identify and can mimic pulmonary metastases. Therefore, considering sarcoidosis as a differential diagnosis whenever first pulmonary metastasis is suspected is warranted. Carefully considered, histological validation of initial suspected pulmonary metastasis may avoid subsequent over- or undertreatment.


Assuntos
Neoplasias Pulmonares/secundário , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Sarcoidose/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoidose/patologia , Sarcoidose/cirurgia , Análise de Sobrevida , Procedimentos Cirúrgicos Torácicos
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