Necrotizing sarcoid granulomatosis mimicking lung cancer in patients with ulcerative colitis in history
Abstract
Necrotizing sarcoid granulomatosis mimicking lung cancer in a patient with a history of ulcerative colitis Necrotizing sarcoid granulomatosis is a rare systemic disease with a predilection for the lung parenchyma, considered a variant of nodular sarcoidosis by some authors. The diagnosis is based on histological examination; the disease has no characteristic clinical, radiological or laboratory findings.
Studies found that patients with idiopathic inflammatory bowel diseases have more frequent lung involvement by idiopathic inflammations than the general population. Presented is a case of a young female with a history of ulcerative colitis suspected of having lung cancer based on a chest CT scan.
A lung lobectomy was indicated but histological examination of the resected tissue failed to confirm lung cancer. After an infectious etiology was ruled out and immunological examination was carried out, necrotizing sarcoid granulomatosis was diagnosed.
For more than 10 years, the patient had not needed treatment for ulcerative colitis and gastroenterological examination did not fInd active disease. It is uncertain whether the two conditions may be associated.
However, a higher risk of lung involvement in patients with idiopathic inflammatory bowel diseases has been reported in the literature, suggesting a common immunopalhological basis. During her follow-up, the patient was found to have an enlarged thymus, arousing suspicion of thymoma.
Since she rejected surgery, the lesion characteristics or potential association with the above condition cannot be dis-cussed.