Abstract
Necrotizing sarcoid granulomatosis (NSG) is a rare disease that shares similarities
with pulmonary vasculitides and sarcoidosis. This is a report of two cases of NSG
with a review of literature. The first case is a 33-year-old black female with a one-year
history of malaise and cough. Lung imaging revealed scattered pulmonary nodules. Histopathology
showed multiple necrotizing granulomas without prominent neutrophilic infiltrates.
The second case is a 58-year-old white female with a one-year history of fatigue,
dyspnea, and ophthalmoplegia on the left eye. Imaging showed multiple pulmonary nodules.
Lung biopsy was consistent with NSG. The challenge of the NSG diagnosis is to distinguish
it from other mimickers. Pathology often shows necrotizing granulomatous vasculitis,
distinguishing it from classical sarcoid. Laboratory markers for vasculitis like neutrophil
cytoplasmic antibodies and antibodies against myeloperoxidase and proteinase 3 are
negative or only low titers. NSG responds well to immune-suppression, most commonly
with glucocorticoids.
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References
- The J. Burns Amberson lecture–pulmonary angiitis and granulomatosis.Am Rev Respir Dis. 1973; 108: 1-18
- Four decades of necrotizing sarcoid granulomatosis: what do we know now?.Arch Pathol Lab Med. 2015; 139: 252-262
- Pulmonary angiitis and granulomatosis revisited.Hum Pathol. 1983; 14: 868-883
- Necrotizing sarcoid granulomatosis with pleural involvement. Clinical and radiographic features.Chest. 1994; 106: 672-676
- Necrotizing sarcoid-like granulomatosis: radiologic-pathologic correlation.J Can Assoc Radiol. 1984; 35: 313-315
- Necrotizing sarcoid granulomatosis.Curr Opin Pulm Med. 2012; 18: 493-498
- Necrotising sarcoid granulomatosis: clinical, functional, endoscopical and radiographical evaluations.Eur Respir J. 2005; 26: 778-785
- Imaging in sarcoidosis.Semin Respir Crit Care Med. 2007; 28: 102-120
- Radiological manifestations of sarcoidosis.Clin Dermatol. 2007; 25: 312-325
- Supraclavicular and axillary lymphadenopathy as the initial manifestation in Wegener's granulomatosis.Clin Rheumatol. 2002; 21: 525-527
- [A case of limited Wegener's granulomatosis with gastroenteritis and mesenteric lymphadenopathy].Korean J Gastroenterol. 2010; 55: 331-335
- Necrotizing granulomatous inflammation: what does it mean if your special stains are negative?.Mod Pathol. 2012; 25: S31-S38
- Necrotizing sarcoid granulomatosis–is it different from nodular sarcoidosis?.Pneumologie. 2003; 57: 268-271
- Anti-TNF-alpha for necrotizing sarcoid granulomatosis of the liver.Hepatology. 2017; 65: 1410-1412
- Necrotizing sarcoid-like granulomatosis: clinical, pathologic, and immunopathologic findings.Hum Pathol. 1980; 11: 510-519
Article info
Publication history
Published online: April 28, 2022
Accepted:
April 22,
2022
Received:
April 12,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
