顎下リンパ節腫脹が診断の契機となったサルコイドーシスの1例

  • 君塚 幸子
    横浜市立大学附属市民総合医療センター歯科・口腔外科・矯正歯科
  • 岡本 喜之
    横浜市立大学附属市民総合医療センター歯科・口腔外科・矯正歯科
  • 青木 伸二郎
    横浜市立大学附属市民総合医療センター歯科・口腔外科・矯正歯科
  • 大村 進
    横浜市立大学附属市民総合医療センター歯科・口腔外科・矯正歯科

書誌事項

タイトル別名
  • A case of sarcoidosis associated with submandibular lymphadenopathy
  • ガク カ リンパセツ シュチョウ ガ シンダン ノ ケイキ ト ナッタ サルコイドーシス ノ 1レイ

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説明

Sarcoidosis is a systemic disease of unknown etiology characterized pathologically by noncaseatingepithelioid cell granulomas affecting any organ. It is often associated with bilateral hilar lymphadenopathy, pulmonaryinfiltration, and skin or eye lesions. We report a case of sarcoidosis with submandibular lymphadenopathy.<br>The patient was a 28-year-old woman who presented with a left submandibular painless nodule. Magnetic resonanceimaging(MRI)revealed a submandibular mass with low intensity on T-1 weighted images and high intensityon T-2 weighted images. Under general anesthesia, resection of the lesion was performed. Histologically thespecimen consisted of numerous noncaseating epithelioid cell granulomas. The histological diagnosis was sarcoidosis,and additional examinations were conducted. Ga-67 scintigraphy bilaterally showed increased uptake inthe lacrimal glands, parotid glands, and hilar lymp nodes. Bilateral hilar lymphadenopathy was confirmed on thoracicCT scanning, and bilateral swelling of the parotid gland was confirmed on MRI. The results of the tuberculinskin test were negative, and the serum levels of angiotensin-converting enzymes and γ-globulin were increased.These findings supported the histological diagnosis. Because the patient was asymptomatic, only careful follow-upwas continued, without treatment. During 24 months of follow-up, bilateral swelling of the parotid gland graduallydecreased, and abnormal uptake of Ga-67 disappeared in all lesions.

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