[Echo-guided splenic biopsy: An effective diagnostic tool in sarcoidosis?]

La biopsie splénique échoguidée : un outil diagnostique efficient au cours de la sarcoidose ?
Biopsie echoguidée Echoguided biopsy Granulomatose Granulomatosis Hypercalcemia Hypercalcémie Sarcoidosis systemic Sarcoïdose systémique

Journal

La Revue de medecine interne
ISSN: 1768-3122
Titre abrégé: Rev Med Interne
Pays: France
ID NLM: 8101383

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 18 02 2019
revised: 31 05 2019
accepted: 06 06 2019
pubmed: 22 6 2019
medline: 15 5 2020
entrez: 22 6 2019
Statut: ppublish

Résumé

Histological diagnosis of systemic granulomatosis may be difficult. The question of the best histological target remains unanswered. We report here the observation of a patient admitted in intensive care unit for severe hypercalcemia in the context of polylymphadenopathy and constitutional symptoms. Assessment of this hypercalcemia was suggestive of systemic granulomatosis. The CT (computed tomodensitometry) revealed lymphadenopathies of the mediastinum and the hepatic hilus, hepatomegaly and heterogeneous splenomegaly. At this stage, our main hypotheses were: lymphoid hematopathy, sarcoidosis, tuberculosis. An echo-guided biopsy of the spleen allowed the histological diagnosis of systemic granulomatosis suggestive of sarcoidosis, without significant complication in the course. This observation illustrates the efficiency and safety of spleen biopsy for the histological diagnosis of systemic granulomatosis.

Sections du résumé

BACKGROUND BACKGROUND
Histological diagnosis of systemic granulomatosis may be difficult. The question of the best histological target remains unanswered.
CASE METHODS
We report here the observation of a patient admitted in intensive care unit for severe hypercalcemia in the context of polylymphadenopathy and constitutional symptoms. Assessment of this hypercalcemia was suggestive of systemic granulomatosis. The CT (computed tomodensitometry) revealed lymphadenopathies of the mediastinum and the hepatic hilus, hepatomegaly and heterogeneous splenomegaly. At this stage, our main hypotheses were: lymphoid hematopathy, sarcoidosis, tuberculosis. An echo-guided biopsy of the spleen allowed the histological diagnosis of systemic granulomatosis suggestive of sarcoidosis, without significant complication in the course.
CONCLUSION CONCLUSIONS
This observation illustrates the efficiency and safety of spleen biopsy for the histological diagnosis of systemic granulomatosis.

Identifiants

pubmed: 31221453
pii: S0248-8663(19)30529-6
doi: 10.1016/j.revmed.2019.06.003
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

fre

Sous-ensembles de citation

IM

Pagination

609-612

Informations de copyright

Copyright © 2019 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

Auteurs

T Frapard (T)

Service de médecine intensive et réanimation, hôpital Saint-Louis, Pr Azoulay, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: thomas.frapard@aphp.fr.

C Le Pendu (C)

Service de médecine interne, hôpital Saint-Louis, Pr Mahr, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: claire.lependu@aphp.fr.

V Meignin (V)

Service d'anatomopathologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: veronique.meignin@aphp.fr.

A Coffin (A)

Service de radiologie, hôpital Saint-Louis, Pr De Kerviler, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: alexandre.coffin@aphp.fr.

E Mariotte (E)

Service de médecine intensive et réanimation, hôpital Saint-Louis, Pr Azoulay, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: eric.mariotte@aphp.fr.

L Zafrani (L)

Service de médecine intensive et réanimation, hôpital Saint-Louis, Pr Azoulay, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: lara.zafrani@aphp.fr.

E Ghrenassia (E)

Service de médecine intensive et réanimation, hôpital Saint-Louis, Pr Azoulay, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: etienne.ghrenassia@aphp.fr.

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Classifications MeSH