Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Isolated Cervical Lymph Node Sarcoidosis Presenting in an Asymptomatic Neck Mass: A Case Report

  • Kwon, Yong Shik (Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Jung, Hye In (Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Hyun Jung (Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, Jin Wook (Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Choi, Won-Il (Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Jin Young (Department of Radiology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Rho, Byung Hak (Department of Radiology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, Hye Won (Department of Pathology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kwon, Kun Young (Department of Pathology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine)
  • Received : 2013.01.23
  • Accepted : 2013.06.17
  • Published : 2013.09.30
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Abstract

Sarcoidosis, a systemic granulomatous disease of unknown etiology. The presentation of sarcoidal granuloma in neck nodes without typical manifestations of systemic sarcoidosis is difficult to diagnose. We describe the case of a 37-year-old woman with an increasing mass on the right side of neck. The excisional biopsy from the neck mass showed noncaseating epithelioid cell granuloma of the lymph nodes. No evidence of mycobacterial or fungal infection was noted. Thoracic evaluations did not show enlargement of mediastinal lymph nodes or parenchymal abnormalities. Immunohistochemistry showed abundant expression of tumor necrosis factor-${\alpha}$ in the granuloma. However, transforming growth factor-${\beta}$ was not expressed, although interleukin-$1{\beta}$ was focally expressed. These immunohistochemical findings supported characterization of the granuloma and the diagnosis of sarcoidosis. Sarcoidosis can present with cervical lymph node enlargement without mediastinal or lung abnormality. Immunohistochemistry may support the diagnosis of sarcoidosis and characterization of granuloma.

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References

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