ENT Department, University Hospital of Patras, Greece.
Eur Rev Med Pharmacol Sci. 2010 Dec;14(12):1097-9.
Sarcoidosis is a granulomatous disease of unknown etiology, which in the majority of cases affects the lower respiratory tract. Although neck mass, parotid swelling and facial nerve palsy are considered the primary complaints in cases of head and neck sarcoidosis, sinonasal localization of the disease is also uncommonly reported.
A 46 year old woman presented in our clinic with complaints of nasal congestion over a six month period. The patient reported increasing symptom severity in the last month with occasional purulent discharge. No other symptoms were reported. The patient's medical record was significant only for sarcoidosis localized to the lower respiratory tract. On anterior rhinoscopy, the nasal mucosa presented marked hypertrophy, purplish discoloration and granulomatous appearance of the inferior turbinates on the left side. The diagnosis of sinonasal sarcoidosis was made based on histopathologic examination of biopsy specimens.
Sinonasal sarcoidosis presents a challenging issue for the clinicial as its mimicking features may be misleading and delay diagnosis. In the present paper we present a case of sinonasal sarcoidosis presenting as chronic rhinosinusitis.
结节病是一种病因不明的肉芽肿性疾病,多数情况下累及下呼吸道。尽管头颈部结节病的主要表现为颈部肿块、腮腺肿胀和面神经瘫痪,但鼻部和鼻窦受累也很少见。
一名 46 岁女性因鼻塞就诊,病程 6 个月。患者称近 1 个月来症状逐渐加重,偶有脓性分泌物。无其他症状。患者的病历仅显示下呼吸道局限性结节病。前鼻镜检查显示左侧下鼻甲黏膜显著肥大、紫绀和肉芽肿样改变。根据活检组织的病理检查,诊断为鼻-鼻窦结节病。
鼻-鼻窦结节病的临床表现具有一定的迷惑性,可能导致误诊,给临床医生带来挑战。本文报告了一例表现为慢性鼻-鼻窦炎的鼻-鼻窦结节病。