Guo M, Lemos L, Baliga M
Department of Pathology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Acta Cytol. 1999 Nov-Dec;43(6):1171-6. doi: 10.1159/000331375.
Symptomatic striated muscle involvement in sarcoidosis is rare. Muscle biopsy is usually required for the diagnosis. Fine needle aspiration biopsy (FNAB) has been successfully used in diagnosing soft tissue lesions. To the best of our knowledge, FNAB of sarcoid myositis has not been reported.
A 31-year-old, black female with a history of sarcoidosis presented with an enlarging, painful, left calf mass. Infected thrombi were suspected. FNAB showed numerous loosely arranged epithelioid histiocytes, multinucleated giant cells and skeletal muscle cells. The overall cytologic picture was that of granulomatous myositis. The cytologic features coupled with the patient's history and magnetic resonance imaging findings suggested sarcoid myositis. Subsequent muscle biopsy showing noncaseating granulomata and negative stains for organisms confirmed the diagnosis of nodular sarcoid myositis.
Nodular sarcoid myositis can be suggested by FNAB cytology in a patient with a past history of sarcoidosis.
结节病累及横纹肌出现症状较为罕见。诊断通常需要进行肌肉活检。细针穿刺活检（FNAB）已成功用于诊断软组织病变。据我们所知，尚未有结节病性肌炎的细针穿刺活检报道。
一名31岁的黑人女性，有结节病病史，出现左小腿肿物且不断增大伴疼痛。怀疑为感染性血栓。细针穿刺活检显示大量排列松散的上皮样组织细胞、多核巨细胞和骨骼肌细胞。整体细胞学表现为肉芽肿性肌炎。细胞学特征结合患者病史及磁共振成像结果提示为结节病性肌炎。随后的肌肉活检显示非干酪样肉芽肿且病原体染色阴性，确诊为结节性结节病性肌炎。
有结节病病史的患者，细针穿刺活检细胞学检查可提示结节性结节病性肌炎。
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