Cases reported "Lymphatic Diseases"

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1/83. sarcoidosis associated with multiple large pulmonary nodules.

    Parenchymal manifestations of pulmonary sarcoidosis include a diffuse, symmetric, reticulonodular interstitial pattern, a fibrotic pattern, and an acinar pattern. Large pulmonary nodules in sarcoidosis are rare, and their frequency (> 1 cm in diameter) has been estimated at 2-4%. We report a rare case of sarcoidosis associated with large bilateral pulmonary nodules. These nodules reached up to 7 cm in diameter, which is larger than any others reported previously. Furthermore, these nodular lesions developed within only 6 months of normal chest X-ray results and were not found to accompany bilateral hilar lymph adenopathy, which is observed in the usual course of sarcoidosis. As described above, this case of pulmonary sarcoidosis was significant not only in terms of the large size of the nodules but also the unique chest X-ray course.
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ranking = 1
keywords = sarcoid, sarcoidosis
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2/83. Carcinoma in villous adenoma of ascending colon associated with sarcoid reaction in the regional lymph nodes.

    A 79-year-old woman was admitted to our hospital due to continuous anal bleeding. colonoscopy showed a huge villous tumor on the middle area of the ascending colon. A typical right colectomy and lymph node dissection were performed. The resected specimen showed a villous type tumor located on the ascending colon. The histopathologic investigation demonstrated a moderately differentiated adenocarcinoma arising in a tubulovillous adenoma and extending to the submucosa. Although there was no evidence of metastatic carcinoma in the dissected lymph nodes, epithelioid cell granulomas with multinucleated giant cells lacking in the central caseous necrosis suggested sarcoid reaction.
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ranking = 0.50488938881962
keywords = sarcoid
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3/83. A case of resectable lung adenocarcinoma associated with sarcoidosis.

    A 71-year-old woman with uveitis was referred to our hospital for further examination of the possible underlying diseases. In roentgenological examination with plain X-ray and CT scan, hilar and mediastinal lymphadenopathy and a mass shadow in the right upper lung field was observed, whereas fibrotic changes were not obvious in both lung fields. Transbronchial lung biopsy with fiberoptic bronchoscope revealed granulomatous interstitial pneumonia. CD4-positive lymphocytes were increased in bronchoalveolar lavage. The patient was diagnosed as having sarcoidosis. Subsequently, right upper lobectomy was performed, and Stage I lung adenocarcinoma was diagnosed. The patient is under follow up without medication and the disease has been stable for two years. A relationship between epithelioid granulomatosis and malignant diseases is discussed and a review of the literature is given. Since it is still controversial as to the incidence of malignant diseases in sarcoidosis patients, it is important to accumulate data on these associations.
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ranking = 1.2
keywords = sarcoid, sarcoidosis
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4/83. Concurrence of sarcoidosis and lung cancer. A report of four cases.

    Although sarcoidosis and lung cancer are both frequently encountered conditions, their simultaneous occurrence in the same patient is unusual. In this report, we describe 4 cases of their concurrence and discuss the possible pathogenic mechanisms of their concurrent appearance. In particular, in 2 of the cases, both diseases had coexisted for a long period (more than 6 and 4 years, respectively), showing a surprisingly slow growth of cancers. Although the chest computed tomography showed hilar and mediastinal lymphadenopathy, the histopathological findings of the excised lymph nodes of both cases revealed no metastasis. The causal relationship between sarcoidosis and lung cancer remains uncertain, but cases such as these may be helpful in elucidating its precise nature.
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ranking = 1.2
keywords = sarcoid, sarcoidosis
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5/83. Unilateral hilar lymphadenopathy of sarcoidosis or sarcoid reaction compressing the trunk of the right pulmonary artery.

    A case of sarcoidosis or sarcoid reaction with a rare manifestation of unilateral lymphadenopathy compressing the trunk of the right pulmonary artery is presented. A 71-year-old woman was admitted for evaluation of a left hilar mass. Chest CT scans showed a mass invading the right pulmonary artery. A frozen section obtained following open lung biopsy showed lymph node tissue largely replaced by noncaseous granulomas indicating sarcoidosis or sarcoid reaction. Old uveitis was compatible with sarcoidosis, and no malignancy was evident. These findings suggested sarcoidosis, however, other evidence of sarcoidosis was not obtained.
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ranking = 2.4058672665835
keywords = sarcoid, sarcoidosis
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6/83. Multiple early gastric cancer associated with sarcoid-like reaction in the regional lymph nodes.

    A 68-year-old man was admitted to our hospital because of epigastric pain. An upper gastrointestinal contrast study and endoscopy revealed a II c type tumor in the posterior wall of the pyloric antrum. and computed tomography showed lymph node enlargement along the left gastric artery. Operation was performed after a presumptive diagnosis of gastric cancer with lymph node involvement. During the laparotomy, more extensive lymphadenopathy was found than was detected preoperatively, and tumor metastasis was suspected because of its firmness. Distal partial gastrectomy with D, and more extensive lymph node dissection were performed. Subsequently, the histology of permanent sections revealed not tumor metastasis but a sarcoid-like reaction in the lymph nodes. The patient recovered uneventfully: however, he was killed in an accident 38 months after the surgery. A postmortem examination was not performed, but there had been no clinical signs of either recurrence of gastric cancer or sarcoidosis.
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ranking = 0.70488938881962
keywords = sarcoid, sarcoidosis
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7/83. PET and PLAP in suspected testicular cancer relapse: beware sarcoidosis.

    A 31-year-old man previously treated with chemotherapy for metastatic testicular cancer presented with new mediastinal lymphadenopathy and peripheral lung opacities. serum tumour markers were not elevated and a PET (positron emission tomography) scan revealed increased FDG (fluoro-deoxyglucose) uptake in the lungs and mediastinum consistent with testis cancer relapse. A biopsy of a mediastinal lymph node was performed and the pathology was that of sarcoidosis. immunohistochemistry however was positive for PLAP (placental alkaline phosphatase) and negative for EMA (epithelial membrane antigen). This immunohistochemical profile raised concerns that the observed pathology represented a sarcoid reaction to micro-metastatic testicular cancer relapse. We performed immunohistochemical pathology analysis on four known cases of sarcoidosis and found the same immunohistochemical-staining pattern. This case highlights the problem of specificity when interpreting the significance of PET scans and immunohistochemical analysis in this situation. sarcoidosis, a condition that has been associated with testicular cancer, should always be considered in the differential diagnosis.
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ranking = 1.3009778777639
keywords = sarcoid, sarcoidosis
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8/83. Increased serum thymidine kinase activity in acute sarcoidosis.

    This is the first case report of acute sarcoidosis with increased serum thymidine kinase (TK) activity. A 43-year-old male presented fever, swelling of parotid glands, lymphadenopathy, and peripheral neuropathy. sarcoidosis was pathologically diagnosed by lung and parotid gland biopsy. His serum TK, which was increased to 11.2 U/l at diagnosis (normal <5 U/l), normalized after glucocorticoid therapy. serum TK has been considered as a good marker of the proliferative activity of various types of neoplasms. Its rise in sarcoidosis has, however, not been described. Because acute sarcoidosis sometimes resembles malignant lymphoma, the possible rise of serum TK in sarcoidosis may be worthy of note.
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ranking = 1.6
keywords = sarcoid, sarcoidosis
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9/83. Unusual association of Hodgkin's disease and sarcoidosis.

    We report a 51-year-old patient who developed abdominal lymphadenopathy following Hodgkin's disease seven years after she was diagnosed as having sarcoidosis. The patient had been treated with steroids, methotrexate and azathioprine. After three cycles of chemotherapy for Hodgkin's disease, the patient again developed sarcoidosis in the mediastinal lymph nodes. A greater awareness of the co-existence of sarcoidosis and Hodgkin's disease could circumvent the diagnostic difficulties.
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ranking = 1.4
keywords = sarcoid, sarcoidosis
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10/83. Fine needle aspiration biopsy cytology as an adjunct in the diagnosis of childhood sarcoidosis.

    Fine needle aspiration biopsy cytology performed in three children with sarcoidosis expedited clinical investigation and diagnosis of their disease. Each patient had a different clinical presentation; in two of them lymphoma was part of the initial differential diagnosis. Aspiration cytology in all cases revealed collections of epithelioid histiocytes, and multinucleate foreign body-type giant cells, without accompanying necrosis or acute inflammation. A diagnosis of non-caseating granulomas consistent with sarcoidosis was made in all aspirates. Special stains for identification of organisms performed on the smears of one case, and culture of aspirate material from one case were negative. Subsequent serum angiotensin converting enzyme levels in all patients were elevated. Chest x-ray films in all patients showed mediastinal and hilar lymphadenopathy. One patient had an interstitial pulmonary infiltrate. All patients responded to steroid therapy. Fine needle aspiration biopsy can be a useful diagnostic tool in the evaluation of children with suspected sarcoidosis.
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ranking = 1.4
keywords = sarcoid, sarcoidosis
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