Two Cases of Sarcoidosis of the Nose and Paranasal Sinuses
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概要
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Sarcoidosis is a granulomatous disease of unknown cause that involves systemic various organs. The diagnosis of sarcoidosis is usually made with histopathological examination, characterized by non-caseating epithelioid granuloma. We report two cases of sarcoidosis of the nasal cavity and paranasal sinuses. Case 1 (paranasal sarcoidosis) is a 44-year-old man, who reported internal compression sensation in the left eye. He had pulmonary sarcoidosis at age 34 and uveitis at age 39. His left eye problem led to a checkup in ophthalmology. Brain MRI showed an abnormal signal in the left frontal and ethmoid sinus. Significant changes had occurred in the nasal cavity. Paranasal CT showed soft tissue density in the left frontal and ethmoid sinus. Gd enhanced, T1-Weighted imaging MRI showed a contrasting effect in the left ethmoid sinus. Intranasal endoscopic surgery identified a fragile granulomatous lesion in the left anterior ethmoid sinus. Histopathological examination showed non caseating epithelioid granuloma resulting in paranasal sarcoidosis. Topical steroid was administered for three months after nasal surgery. Case 2 (nasal cavity sarcoidosis) is a 42-year-old man. He reported nasal obstruction, discharge, and intranasal dryness. He had pulmonary sarcoidosis at age 20, uveitis at age 32, and nerve sarcoidosis at age 35. He suffered from nasal obstruction, discharge, and intranasal dryness for 12 years. Dermal sarcoid was seen in the frontal skin. Nasal mucosa were covered by a crust of blood and exudate. Paranasal CT and MRI showed abnormal density in the left ethmoid sinus, maxillary antrum, and frontal sinus. Intranasal surgery was recommended, but no informed concent was obtained. Mucosal biopsy from the left inferior nasal turbinate was performed and a definite diagnosis of sarcoidosis was made. Topical steroid therapy was not administered at the patient's request.
- 日本鼻科学会の論文
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