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Vol. 15. Issue 3.
Pages 543-552 (May - June 2009)
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Vol. 15. Issue 3.
Pages 543-552 (May - June 2009)
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Sarcoidosis: A less common presentation
Sarcoidose: Uma forma rara de apresentação
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Jessica Cemlyn-Jones1, Fernanda Gamboa2, Luísa Teixeira3, João Bernardo4, Carlos Robalo Cordeiro5, Loureiro Mário Chaves6, Fontes Baganha Doutor Manuel6, Pinto Mota6
1 Interna Complementar de Pneumologia
2 Assistente Hospitalar de Pneumologia
3 Chefe de Serviço de Radiodiagnóstico
4 Chefe de Serviço de Cirurgia Cardiotorácica
5 Coordenador da Unidade Funcional de Técnicas de Diagnóstico e Terapêutica Hospitais da Universidade de Coimbra
6 Departamento de Ciências Pneumológicas e Alergológicas dos Hospitais da Universidade de Coimbra, Av. Bissaya Barreto e Praceta, 3000-075 Coimbra.
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Abstract

The clinical presentation of sarcoidosis is diverse and in over 90% of patients there is pulmonary involvement. The most common features of the radiographic findings at the time of diagnosis are bilateral hilar lymphadenopathy and pulmonary infiltration.

The authors report the case of a young female patient who presented with multiple bilateral nodular shadows on chest radiograph. Surgical biopsy revealed non-necrotizing granulomas with occasional multinucleated giant cells compatible with sarcoidosis.

Al-though this was a case of stage III pulmonary disease, the patient was asymptomatic, lung function tests were normal and there were no signs of extrathoracic involvement. Spontaneous remission occurred without treatment as shown on high resolution CT scan follow-up, one year later.

Key-words:
Sarcoidosis
multiple bilateral nodular shadows
spontaneous remission
Resumo

A apresentação clínica da sarcoidose é diversa e em mais de 90% dos casos existe envolvimento pulmonar. Os achados radiológicos mais frequentes aquando do diagnóstico são a presença de adenopatias hilares e infiltrados pulmonares.

Os autores apresentam o caso de uma doente jovem cuja radiografia torácica apresentava múltiplos nódulos bilaterais. A biópsia cirúrgica revelou a presença de granulomas não necrotizantes com células gigantes multinucleadas, compatível com sarcoidose.

Apesar de se tratar de uma sarcoidose pulmonar estádio III, a doente apresentava-se assintomática, o estudo funcional ventilatório era normal e não havia sinais de envolvimento extratorácico, pelo que foi decidido não iniciar tratamento. Houve remissão espontânea das lesões, comprovada em tomografia computorizada de alta resolução após um ano.

Palavras-chave:
Sarcoidose
múltiplos nódulos pulmonares bilaterais
remissão espontânea
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Copyright © 2009. Sociedade Portuguesa de Pneumologia
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