Presentation
Further evaluation was requested following pre-employment check-up.
Patient Data
Bilateral multiple masslike spiculated consolidations with air bronchograms located in the peri broncho-vascular bundles and subpleural spaces, without calcification or enhancement.
Bilateral hilar and mediastinal lymphadenopathy.
Case Discussion
PATHOLOGY REPORT
MICROSCOPIC:
(1) Sections of the lymph node show total effacement of nodal architecture by
multiple, small, non- caseating, punched out epithelioid granulomas with few
multinucleated giant cells. Z.N stain for acid-fast bacilli is negative. No malignancy seen in the levels examined.
(2) Sections of the lung show few scattered interstitial epithelioid granulomas with multinucleated giant cells. No caseation. No malignancy was seen.
(3) Sections of the pleura show mild fibrosis. No evidence of inflammation,
granulomas or malignancy seen in the levels examined.
DIAGNOSIS:
(1) Mediastinal lymph node, excisional biopsy: granulomatous lymphadenitis, suggestive of sarcoidosis
(2) Lung wedge, biopsy: involvement by granulomatous inflammation
(3) Pleura, biopsy: no specific histopathological changes
CONCLUSION
The radiological features and histopathology report are in keeping with sarcoidosis.