[A case of sarcoidosis with systemic lymph node involvement presenting as multiple high-density masses on chest and abdominal CT].
We report a case of sarcoidosis with mediastinal and abdominal lymph node involvement presenting as multiple high-density masses on chest and abdominal CT. The patient was a 43-year-old housewife who came to our hospital because of a dry cough and exertional dyspnea. A chest radiograph showed bilateral diffuse reticulo-nodular shadows and widening of the mediastinum. On CT of the chest and the abdomen, lymph nodes were swollen throughout the mediastinum and the para-aortic area of the abdomen. They appeared as very-high-density masses on plain CT. Bronchoscopy revealed involvement of the bronchial walls. Punch biopsy of the bronchial wall, TBLB, and biopsy of the anterior mediastinal lymph node all revealed non-caseous epithelioid cell granulomas. These granulomas contained lamellated, irregularly shaped and darkly-stained structures (Schaumann bodies) that caused the high density of the involved lymph nodes on CT. This case shows at least a part of the mechanism of calcification of lymph node lesions in patients with sarcoidosis.
Hasegawa
T
T
Department of Respiratory Diseases, Kobe City General Hospital.
Matsumoto
H
H
Tomioka
H
H
Okazaki
M
M
Katakami
N
N
Sakamoto
H
H
Ishihara
K
K
Umeda
B
B
D000328:Adult; D002114:Calcinosis / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008482:Mediastinum; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed