KEMİK TUTULUMU İLE METASTATİK KANSERİ TAKLİT EDEN PULMONER SARKOİDOZ OLGUSU

Sarkoidoz etyolojisi bilinmeyen, özellikle akciğer ile lenf bezlerini, cildi, gözleri ve diğer organları tutabilen; fakat nadiren kemik ve kemik iliğini tutan bir hastalıktır. Otuz dokuz yaşında, iliak kemikte maligniteyi taklit eden lezyonu olan, biyopsi ile sarkoidoz olduğu kanıtlanan bir erkek hastayı sunduk. Lenfoma veya metastatik kanser ayırıcı tanısı yapmak son derece zordu. Hastaya akciğer ve iliak kemikten birçok biyopsi yapıldı. Hepsinin sonucu nonnekrotizan granulomatöz inflamasyon olarak raporlandı. Hastaya kortikosteroid tedavisi başlandı. Steroid tedavisine yeterli yanıt alınamayan hastanın steroid tedavisine metotreksat ilave edildi. Bunun sonrasında klinik ve radyolojik iyileşme kaydedildi. Bu olguda, maligniteyi benign bir hastalıktan ayırt edebilmek ve tanıyı doğrulamak için yeni biyopsilerle ytekrarlanan histopatolojik değerlendirmenin öneminin vurgulanması hedeflendi.

Anahtar Kelimeler:

Sarkoidoz, ayırıcı tanı, malignite

PULMONARY SARCOIDOSIS WITH BONE INVOLVEMENT MIMICKING METASTATIC CANCER

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,

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