Weekly Chest CasesArchive of Old Cases

Case No : 895 Date 2014-12-22

  • Courtesy of Bo Mi Chung MD, Jae Seung Seo, Semin Chong MD / Chung-Ang University Hospital
  • Age/Sex 28 / M
  • Chief ComplaintAbnormal chest radiograph, Past history of asthma
  • Figure 1
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  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Sarcoidosis
Radiologic Findings
Chest radiograph shows multiple ground glass opacities in both lungs. Non-enhanced chest CT taken on the same day shows multiple nodules or mass with or without surrounding ground glass opacities (GGO) and segmental GGOs in both lungs.
Multiple enlarged lymph nodes are noted in the mediastinum.
Subtle perilymphatic distributed micronodules within segmental GGOs are seen on the magnified image.

Laboratory data showed mildly elevated hs-CRP, but other laboratory data including eosinophil count /sputum study depicted within normal range. No endobronchial lesion was found on diagnostic bronchoscopy.
Percutaneous biopsy was done for the spiculated mass lesion in the right upper lobe and pathologic examination revealed chronic granulomatous inflammation without caseous necrosis and negative AFB staining.Follow up chest radiograph 2 weeks after steroid therapy showed improved multiple nodules/mass or GGOs in both lungs.

after steroid therapy

Brief Review
Please refer to
Case 456, Case 533,
References
Keywords
Lung, Non-infectious inflammation,

No. of Applicants : 81

▶ Correct Answer : 21/81,  25.9%
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - the First Affiliated Hospital of NanJing Medical University , China Aiping Chen
  • - Seoul National University Hospital , Korea (South) Hyoung-In Choi
  • - McGill University Health Center , Canada Alexandre Semionov
  • - AMC health promotion cencer , Korea (South) Hanna Noh
  • - GHICL , France manuel toledano
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Chosun university hospital , Korea (South) Hyungwoo Oh
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - CHU POITIERS , France SZTARK Guillaume
  • - CHU Poitiers , France CHAN paul
  • - Onomichi Municipal Hospital , Japan Yoshihisa Masaoka
  • - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
  • - Gifu Central Hospital , Japan Haruo Watanabe
  • - Kyoto University , Japan Akihiko Sakata
  • - The University of Tokyo Hospital , Japan Takeyuki Watadani
  • - chp st martin , France Mariotte benoit
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
▶ Correct Answer as Differential Diagnosis : 14/81,  17.3%
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - SNUH , Korea (South) Eui Jin Hwang
  • - Hopital Avignon , France Florin Muste
  • - Hanyang universitiy, radiology department , Korea (South) HyunGyu Lee
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - Freelance resident in Reunion Island , Reunion Fabien HO
  • - medical university of isfahan , Iran pouya akbari
  • - Chonbuk National University Hospital , Korea (South) Eunyoung Kim
  • - UZA , Belgium Eline De Smet
  • - Private sector , Greece Vasilios Tzilas
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

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