PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER/KEMIK TUTULUMU ILE METASTATIK KANSERI TAKLIT EDEN PULMONER SARKOIDOZ OLGUSU

• Published in: İstanbul Tıp Fakültesi dergisi = Journal of the Istanbul Faculty of Medicine Vol. 85; no. 1; p. 125
• Main Authors: Sahinoglu, Ece, Ilgazli, Ahmet Hamdl
• Format: Journal Article
• Language: English
• Published: AVES 01.03.2022
• Subjects: Care and treatment; Diagnosis; Diagnosis, Differential; Dosage and administration; Metastasis; Methods; Methotrexate; Risk factors; Sarcoidosis; Turkey
• ISSN: 1305-6433
• DOI: 10.26650/IUITFD.853034

Sarcoidosis is a disease of unknown etiology which can affect the lungs and lymph nodes, skin, eyes and other organs and, in rare cases, bones and bone marrow cells. We present a case of a 39-year-old male patient with an iliac bone involvement of sarcoidosis mimicking malignancy. Lymphoma and metastatic cancer proved a challenge to discard in differential diagnosis. He underwent multiple biopsies including tru-cut lung parenchyma and iliac bone biopsies. All of the biopsy specimens were reported as non-necrotising granulomatous inflammation. He underwent corticosteroid treatment. His response to the steroid treatment was insufficient so methotrexate was added to the corticosteroid therapy. Afterwards, clinical and radiological improvement was recorded. We aimed to highlight the utilization of taking new biopsies and histopathological re-evaluations in order to confirm the diagnosis and distinguish a benign disease from a malignant one. Keywords: Sarcoidosis, differential diagnosis, malignancy Sarkoidoz, etyolojisi bilinmeyen, ozellikle akciger ile lenf bezlerini, cildi, gozleri ve diger organlari tutabilen; fakat nadiren kemik ve kemik iligini tutan bir hastaliktir. Otuz dokuz yasinda, iliak kemikte maligniteyi taklit eden lezyonu olan, biyopsi ile sarkoidoz oldugu kanitlanan bir erkek hastayi sunduk. Lenfoma veya metastatik kanser ayirici tanisi yapmak son derece zordu. Hastaya akciger ve iliak kemikten bircok biyopsi yapildi. Hepsinin sonucu nonnekrotizan granulomatoz inflamasyon olarak raporlandi. Hastaya kortikosteroid tedavisi baslandi. Steroid tedavisine yeterli yanit alinamayan hastanin steroid tedavisine metotreksat ilave edildi. Bunun sonrasinda klinik ve radyolojik iyilesme kaydedildi. Bu olguda, maligniteyi benign bir hastaliktan ayirt edebilmek ve taniyi dogrulamak icin yeni biyopsilerle ytekrarlanan histopatolojik degerlendirmenin oneminin vurgulanmasi hedeflendi. Anahtar Kelimeler: Sarkoidoz, ayirici tani, malignite