The Gray Area of Sarcoidosis and Tuberculosis: A Diagnostic Enigma.

Cureus

Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

Published: October 2024

AI Article Synopsis

  • A 29-year-old male patient exhibited symptoms that could point to either tuberculosis (TB) or sarcoidosis, and imaging studies showed abnormal lung findings.
  • A biopsy indicated necrotizing granulomatous inflammation, suggesting TB, but his symptoms did not improve with TB treatment, leading to a diagnosis of pulmonary sarcoidosis.
  • The patient's condition improved significantly with corticosteroid therapy, demonstrating the need for thorough diagnostic evaluations to differentiate between these two diseases.

Article Abstract

This case report presents a challenging diagnostic enigma, where a 29-year-old male patient presented with symptoms and signs favoring both tuberculosis (TB) and sarcoidosis. The patient's plain chest radiograph showed bilateral hilar opacities, while a contrast-enhanced computed tomography (CECT) scan revealed multiple mediastinal and hilar lymph nodes. Histopathology of a mediastinal lymph node biopsy showed necrotizing granulomatous inflammation, favoring TB. However, the patient's symptoms did not resolve with antitubercular treatment, and further investigations revealed a working diagnosis of pulmonary sarcoidosis. The patient's symptoms improved with corticosteroid therapy, and subsequent plain chest radiographs and high-resolution computed tomography (HRCT) scans showed near complete resolution of lung infiltrates. This case highlights the importance of careful evaluation and interpretation of biopsy results and the use of advanced diagnostic techniques to diagnose and differentiate between TB and sarcoidosis accurately.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569424PMC
http://dx.doi.org/10.7759/cureus.71763DOI Listing

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