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  • Title: [A case of sarcoidosis with systemic lymph node involvement presenting as multiple high-density masses on chest and abdominal CT].
    Author: Hasegawa T, Matsumoto H, Tomioka H, Okazaki M, Katakami N, Sakamoto H, Ishihara K, Umeda B.
    Journal: Nihon Kyobu Shikkan Gakkai Zasshi; 1994 Nov; 32(11):1125-30. PubMed ID: 7815770.
    Abstract:
    We report a case of sarcoidosis with mediastinal and abdominal lymph node involvement presenting as multiple high-density masses on chest and abdominal CT. The patient was a 43-year-old housewife who came to our hospital because of a dry cough and exertional dyspnea. A chest radiograph showed bilateral diffuse reticulo-nodular shadows and widening of the mediastinum. On CT of the chest and the abdomen, lymph nodes were swollen throughout the mediastinum and the para-aortic area of the abdomen. They appeared as very-high-density masses on plain CT. Bronchoscopy revealed involvement of the bronchial walls. Punch biopsy of the bronchial wall, TBLB, and biopsy of the anterior mediastinal lymph node all revealed non-caseous epithelioid cell granulomas. These granulomas contained lamellated, irregularly shaped and darkly-stained structures (Schaumann bodies) that caused the high density of the involved lymph nodes on CT. This case shows at least a part of the mechanism of calcification of lymph node lesions in patients with sarcoidosis.
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