Diagnosis of pulmonary sarcoidosis comorbid with non-specific interstitial pneumonia: a case report.
Imaging presentation
Non-specific interstitial pneumonia
Pulmonary sarcoidosis
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
09 Oct 2024
09 Oct 2024
Historique:
received:
03
06
2024
accepted:
01
10
2024
medline:
10
10
2024
pubmed:
10
10
2024
entrez:
9
10
2024
Statut:
epublish
Résumé
Although the imaging manifestations of pulmonary sarcoidosis have been described in detail in previous studies, a consensus has not been reached on the imaging presentation of non-specific interstitial pneumonia (NSIP) lookalike pattern as a distinct pattern in the diagnosis of pulmonary sarcoidosis in high-resolution computed tomography (HRCT). No cases of pulmonary sarcoidosis comorbid with NSIP have been reported. A 53-year-old male presented to the hospital with a five-year history of recurrent coughing up sputum and a four-year history of shortness of breath. In addition to the typical features of pulmonary sarcoidosis, the patient's HRCT also showed unexpected interstitial changes in the lower lobes of both lungs, suggesting an NSIP pattern. Histopathology of the lung tissue in this region confirmed well-formed noncaseating epithelioid granulomas and pathological modifications of NSIP. After a rigorous exclusion diagnosis combining the patient's clinical features, radiological and pathological findings, we diagnosed this patient with pulmonary sarcoidosis comorbid with NSIP. This suggests that NSIP may act as a rare comorbidity of pulmonary sarcoidosis thereby resulting in the patient's HRCT presenting differently from routine sarcoidosis imaging.
Sections du résumé
BACKGROUND
BACKGROUND
Although the imaging manifestations of pulmonary sarcoidosis have been described in detail in previous studies, a consensus has not been reached on the imaging presentation of non-specific interstitial pneumonia (NSIP) lookalike pattern as a distinct pattern in the diagnosis of pulmonary sarcoidosis in high-resolution computed tomography (HRCT). No cases of pulmonary sarcoidosis comorbid with NSIP have been reported.
CASE PRESENTATION
METHODS
A 53-year-old male presented to the hospital with a five-year history of recurrent coughing up sputum and a four-year history of shortness of breath. In addition to the typical features of pulmonary sarcoidosis, the patient's HRCT also showed unexpected interstitial changes in the lower lobes of both lungs, suggesting an NSIP pattern. Histopathology of the lung tissue in this region confirmed well-formed noncaseating epithelioid granulomas and pathological modifications of NSIP. After a rigorous exclusion diagnosis combining the patient's clinical features, radiological and pathological findings, we diagnosed this patient with pulmonary sarcoidosis comorbid with NSIP.
CONCLUSIONS
CONCLUSIONS
This suggests that NSIP may act as a rare comorbidity of pulmonary sarcoidosis thereby resulting in the patient's HRCT presenting differently from routine sarcoidosis imaging.
Identifiants
pubmed: 39385123
doi: 10.1186/s12890-024-03316-y
pii: 10.1186/s12890-024-03316-y
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
497Subventions
Organisme : the National Natural Science Foundation of China
ID : 82173182
Organisme : the Science and Technology Program of Sichuan
ID : 2023NSFSC1939
Informations de copyright
© 2024. The Author(s).
Références
Judson MA. The clinical features of sarcoidosis: a Comprehensive Review. Clin Rev Allergy Immunol. 2015;49(1):63–78. https://doi.org/10.1007/s12016-014-8450-y .
doi: 10.1007/s12016-014-8450-y
pubmed: 25274450
Arkema EV, Cozier YC. Epidemiology of sarcoidosis: current findings and future directions. Ther Adv Chronic Dis. 2018;9(11):227–40. https://doi.org/10.1177/2040622318790197 .
doi: 10.1177/2040622318790197
pubmed: 30364496
pmcid: 6196636
Kirkil G, Lower EE, Baughman RP. Predictors of Mortality in Pulmonary Sarcoidosis. Chest. 2018;153(1):105–13. https://doi.org/10.1016/j.chest.2017.07.008 .
doi: 10.1016/j.chest.2017.07.008
pubmed: 28728933
Belperio JA, Shaikh F, Abtin FG, et al. Diagnosis and treatment of pulmonary sarcoidosis: a review. JAMA. 2022;327(9):856–67. https://doi.org/10.1001/jama.2022.1570 .
doi: 10.1001/jama.2022.1570
pubmed: 35230389
Costabel U. Sarcoidosis: clinical update. Eur Respir J Suppl. 2001;32:s56–68.
Bailey GL, Wells AU, Desai SR. Imaging of pulmonary Sarcoidosis-A review. J Clin Med. 2024;13(3):822. https://doi.org/10.3390/jcm13030822 .
doi: 10.3390/jcm13030822
pubmed: 38337517
pmcid: 10856519
Desai SR, Sivarasan N, Johannson KA, et al. High-resolution CT phenotypes in pulmonary sarcoidosis: a multinational Delphi consensus study. Lancet Respir Med. 2024;12(5):409–18. https://doi.org/10.1016/S2213-2600(23)00267-9 .
doi: 10.1016/S2213-2600(23)00267-9
pubmed: 38104579
Crouser ED, Maier LA, Wilson KC, et al. Diagnosis and detection of Sarcoidosis. An official American thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2020;201(8):e26–51. https://doi.org/10.1164/rccm.202002-0251ST .
doi: 10.1164/rccm.202002-0251ST
pubmed: 32293205
pmcid: 7159433
Obi ON. Pulmonary sarcoidosis: beyond restriction and forced vital capacity. Ann Am Thorac Soc. 2023;20(1):24–6. https://doi.org/10.1513/AnnalsATS.202208-731ED .
doi: 10.1513/AnnalsATS.202208-731ED
pubmed: 36584989
pmcid: 9819261
Chopra A, Nautiyal A, Kalkanis A, Judson MA. Drug-Induced Sarcoidosis-Like reactions. Chest. 2018;154(3):664–77. https://doi.org/10.1016/j.chest.2018.03.056 .
doi: 10.1016/j.chest.2018.03.056
pubmed: 29698718
Hamblin M, Prosch H, Vašáková M. Diagnosis, course and management of hypersensitivity pneumonitis. Eur Respir Rev off J Eur Respir Soc. 2022;31(163):210169. https://doi.org/10.1183/16000617.0169-2021 .
doi: 10.1183/16000617.0169-2021
Costabel U, Miyazaki Y, Pardo A, et al. Hypersensitivity pneumonitis. Nat Rev Dis Primer. 2020;6(1):65. https://doi.org/10.1038/s41572-020-0191-z .
doi: 10.1038/s41572-020-0191-z
Zhu J, Zhou D, Wang J, et al. A causal Atlas on comorbidities in Idiopathic Pulmonary Fibrosis: a bidirectional mendelian randomization study. Chest. 2023;164(2):429–40. https://doi.org/10.1016/j.chest.2023.02.038 .
doi: 10.1016/j.chest.2023.02.038
pubmed: 36870387
Wijsenbeek M, Suzuki A, Maher TM. Interstitial lung diseases. Lancet Lond Engl. 2022;400(10354):769–86. https://doi.org/10.1016/S0140-6736(22)01052-2 .
doi: 10.1016/S0140-6736(22)01052-2
Walsh SLF, Wells AU, Sverzellati N, et al. Relationship between fibroblastic foci profusion and high resolution CT morphology in fibrotic lung disease. BMC Med. 2015;13:241. https://doi.org/10.1186/s12916-015-0479-0 .
doi: 10.1186/s12916-015-0479-0
pubmed: 26399508
pmcid: 4581474
Chopra A, Avadhani V, Tiwari A, Riemer EC, Sica G, Judson MA. Granulomatous lung disease: clinical aspects. Expert Rev Respir Med. 2020;14(10):1045–63. https://doi.org/10.1080/17476348.2020.1794827 .
doi: 10.1080/17476348.2020.1794827
pubmed: 32662705
Spagnolo P, Rossi G, Trisolini R, Sverzellati N, Baughman RP, Wells AU. Pulmonary sarcoidosis. Lancet Respir Med. 2018;6(5):389–402. https://doi.org/10.1016/S2213-2600(18)30064-X .
doi: 10.1016/S2213-2600(18)30064-X
pubmed: 29625772
Kinder BW. Nonspecific interstitial pneumonia. Clin Chest Med. 2012;33(1):111–21. https://doi.org/10.1016/j.ccm.2011.11.003 .
doi: 10.1016/j.ccm.2011.11.003
pubmed: 22365250