A Case of Sarcoidosis That Was Initially Misdiagnosed as Nontuberculous Mycobacteria Pulmonary Disease.

Choi, Hyun Ho; Hong, Yu Ah; Choi, Jae Ki; Kim, Ju Sang; Kim, Seung Joon; Kim, Seok Chan; Lee, Sook Young; Kim, Young Kyoon; Park, Sung Hak; Kim, Tae Jung; Lee, Kyo Young; Park, Hyun Jin; Kim, Hyo Lim; Ahn, Myeong Im

doi:2009.66.4.309

Tuberc Respir Dis > Volume 66(4); 2009 > Article

Case Report

Tuberculosis and Respiratory Diseases 2009;66(4):309-313.
DOI: https://doi.org/10.4046/trd.2009.66.4.309 Published online April 1, 2009.

A Case of Sarcoidosis That Was Initially Misdiagnosed as Nontuberculous Mycobacteria Pulmonary Disease.

Hyun Ho Choi, Yu Ah Hong, Jae Ki Choi, Ju Sang Kim, Seung Joon Kim, Seok Chan Kim, Sook Young Lee, Young Kyoon Kim, Sung Hak Park, Tae Jung Kim, Kyo Young Lee, Hyun Jin Park, Hyo Lim Kim, Myeong Im Ahn

¹Division of Pulmonology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea. cmcksj@catholic.ac.kr
²Department of Hospital Pathology, The Catholic University of Korea, Seoul, Korea.
³Department of Radiology, The Catholic University of Korea, Seoul, Korea.

Abstract

There are several respiratory diseases that show chronic granulomatous inflammation for the histologic finding. Among them, sarcoidosis and tuberculosis are not easy to differentiate when the clinical and radiological features present similar patterns. The increasing incidence of nontuberculous mycobacteria pulmonary disease is making it more difficult for clinicians to arrive at a proper diagnosis. A 69 year old male patient visited our hospital with chronic cough as his chief compliant. His radiologic findings were multiple enlarged mediastinal lymphadenpathies with innumerable micronodules and multiple patch infiltrations. The spleen biopsy finding showed chronic granulomatous inflammation, and Mycobacterium avium was identified on the bronchoscopic culture. Because of these findings, we treated him with drugs for nontuberculous mycobacteria disease other than sarcoidosis. However, during the treatment, his symptoms and radiological features became aggravated. Thus, we reviewed the radiologic and pathologic findings and decided to treat him with steroid, which relieved his symptoms and improved the radiologic findings. We report here on a case of sarcoidosis that was initially misdiagnosed as nontuberculous mycobacteria pulmonary disease.

Key Words: Sarcoidosis, Nontuberculous mycobacteria pulmonary disease, Chronic granulomatous inflammation