Tuberc Respir Dis.  2011 May;70(5):433-437.

Sarcoidosis Occured after Treatment of Tuberculous Lymphadenitis

• Lee HJ
• Yoon SY
• Han JM
• An JH
• Lee JJ
• Choi CM
• Oh YM
• Shim TS
• Lee SD
• Kim WS
• Kim DS
• Song JW

Abstract

Sarcoidosis is a multisystemic disorder characterized by the presence of non-caseating granulomas in the involved organ. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is characterized by granuloma with caseous necrosis. The clinical and histological similarity between sarcoidosis and tuberculosis has stimulated research searching for an association between mycobacterium and sarcoidosis. We report a case of a 38-year-old male with sarcoidosis that developed soon after treatment of tuberculous lymphadenitis. He was diagnosed as tuberculous lymphadenitis by microbiological confirmation. He showed clinical improvement after treatment for tuberculosis. One year later, his chest radiography showed bilateral hilar enlargement with diffuse bilateral nodules. A noncaseating granuloma was confirmed by endobronchial ultrasound guided transbronchial needle aspiration and he was diagnosed with sarcoidosis. To our knowledge, this is the first report describing sarcoidosis after treatment of tuberculosis in South Korea.

Keyword

Sarcoidosis; Tuberculosis; Granuloma

MeSH Terms

Adult
Communicable Diseases
Granuloma
Humans
Male
Mycobacterium
Mycobacterium tuberculosis
Necrosis
Needles
Republic of Korea
Sarcoidosis
Thorax
Tuberculosis
Tuberculosis, Lymph Node

Figure

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  Figure 1 (A) Chest CT shows multiple lymph node enlargement with inner necrotic portion (arrows). (B) After 6 months of treatment for tuberculosis, lymph node size was reduced (arrow heads). CT: computed tomography.

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  Figure 2 Histological findings of subcarinal lymph node shows chronic granulomatous inflammation and necrotic debri (arrows) (H&E stain, ×200).

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  Figure 3 (A) Chest radiography shows bilateral hilar enlargement with diffuse bilateral nodules. (B) After 2 months of steroid treatment, bilateral hilar lymph node size was reduced.

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  Figure 4 Chest CT shows bilateral mediastinal and hilar lymphadenopathy, and disseminated nodules. CT: computed tomography.

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  Figure 5 Histological findings of mediastinal lymph node shows non-caseating granuloma consistent with sarcoidosis (H&E stain, ×200).

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