Miyashita Tomoko, Yoshioka Katsunobu, Nakamura Tomoyuki, Yamagami Keiko
Department of Internal Medicine, Osaka City General Hospital, Osaka 534-0021, Japan.
Case Rep Pulmonol. 2011;2011:268620. doi: 10.1155/2011/268620. Epub 2011 Sep 15.
A 54-year-old woman with a past history of silicone augmentation mammoplasty was admitted with fever and dyspnea with diffuse interstitial shadows on computed tomography (CT). Although radiological findings were atypical, we diagnosed sarcoidosis by laboratory, microbiological, and bronchoalveolar lavage fluid analysis. Corticosteroids ameliorated the condition, but she had recurrent of fever and CT revealed miliary nodules while interstitial shadows disappeared. Liver biopsy showed that noncaseating granuloma and Ziehl-Neelsen stain was positive. We diagnosed miliary tuberculosis which developed during corticosteroid therapy. Antituberculotic therapy resulted in favorable outcome. Possibility exists that onset of sarcoidosis was induced by mammoplasty, namely, human adjuvant disease.
一名有硅胶隆乳术病史的54岁女性因发热和呼吸困难入院,计算机断层扫描(CT)显示弥漫性间质阴影。尽管放射学表现不典型,但我们通过实验室、微生物学和支气管肺泡灌洗液分析诊断为结节病。皮质类固醇改善了病情,但她反复发热,CT显示粟粒结节,而间质阴影消失。肝活检显示非干酪样肉芽肿,齐-尼氏染色呈阳性。我们诊断为皮质类固醇治疗期间发生的粟粒性肺结核。抗结核治疗取得了良好效果。存在结节病的发病可能是由隆乳术诱发的可能性,即人类辅助性疾病。