4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

4. Hrvatski kongres kliniËke citologije / 1. Hrvatski simpozij analitiËke citologije / 2. Hrvatski simpozij citotehnologije
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Klinička citologija - Usmena predavanja
NECROTISING SARCOID GRANULOMATOSIS OF THE SPINAL CORD: CASE REPORT
Vrbica Ž1 , Boras Z2 , Rakušić N2 , Smojver-Ježek S2 , Baričević D2 , Rakušić N3 , Alerić I2 1 Dubrovnik General Hospital, Dubrovnik, Croatia
2 University Hospital for Lung Diseases, Zagreb, Craotia
3 Medical Faculty, Rijeka, Croatia.
We report a patient with leg weakness and cervical lymphadenopathy. Magnetic resonance
showed an inhomogenously increased signal in the thickened portion of the cord.
Multilevel laminectomy and spinal cord biopsy revealed granulomatous infiltrations with
necrosis. Review of the histopathological finding established the diagnosis of necrotising
sarcoid granulomatosis (NSG) of the spinal medulla, and cytological and histopathological
analysis of the neck lymph node disclosed granulomatous inflammation without
necrosis. Further radiographic chest evaluation showed mediastinal lymphadenopathy.
Immunophenotyping of lymphocytes in bronchoalveolar lavage fluid (BALF) was indicative
of sarcoidosis. The patient clinicaly improved to corticosteroid therapy, and lymph
nodes subsided with minor changes remaining in the spinal medulla, which were considered
to be irreversible. To our knowledge, this is the first described case with finding
of granulomatous inflammation with and without vasculitis in various organs, consistent
with the study of Churg who believes NSG to be a histological variant of sarcoidosis.
zarkov@bolnica-du.hr