PDF(Pubmed)
Abstract：
Sarcoidosis is an idiopathic multisystem disorder with unknown etiology. Due to clinical similarities among sarcoidosis, tuberculosis (TB) infection and malignant diseases (such as lymphoma, lung carcinoma and pituitary tumor), the diagnosis of sarcoidosis is challenging. The present report describes a case of sarcoidosis in a 48-year-old male with complaint of chest pain 1 month after Coronavirus disease 2019. The patient underwent whole-body 18F-fluorodeoxyglucose (18F-FDG) PET-CT imaging, which revealed multiple lymphadenopathies throughout the body without lung parenchyma involvement. Biochemical examinations such as T-SPOT.TB test and pathological examination of right supraclavicular lymph node revealed positive T-SPOT.TB but negative Ziehl-Neelsen staining. However, non-caseating epithelioid granulomas were observed in the mediastinal biopsy, indicating the diagnosis of sarcoidosis. The patient was clinically stable, and the symptom of chest pain was gradually relieved without any specific treatment. Outpatient follow-up continued every 3 months. The present case suggested a possible link between coronavirus infection and sarcoidosis, which suggests the advantages of 18F-FDG PET-CT for the detection of sarcoidosis. However, T-SPOT.TB is insufficient for differentiating between sarcoidosis and TB.
摘要：
结节病是一种病因不明的特发性多系统疾病。由于结节病之间的临床相似性，结核病（TB）感染和恶性疾病（如淋巴瘤，肺癌和垂体肿瘤)，结节病的诊断具有挑战性.本报告描述了一名48岁男性结节病病例，在2019年冠状病毒疾病后1个月主诉胸痛。患者接受了全身18F-氟代脱氧葡萄糖（18F-FDG）PET-CT成像，显示全身多发淋巴结病，无肺实质受累。生化检查，如T-SPOT。右侧锁骨上淋巴结结核及病理检查提示T-SPOT阳性。TB但Ziehl-Neelsen染色阴性。然而,在纵隔活检中观察到非癌性上皮样肉芽肿，提示结节病的诊断。病人临床稳定,胸痛症状逐渐缓解，无需任何特异性治疗。每3个月继续门诊随访。目前的病例表明冠状病毒感染和结节病之间可能存在联系，这表明18F-FDGPET-CT用于检测结节病的优势。然而,T-SPOT。TB不足以区分结节病和TB。
