Şahin N, Solak A, Karaarslan S, Doruk S
a Department of Obstetrics and Gynecology , Sifa University Medicine School , Izmir , Turkey ;
b Department of Radiodiagnostic , Sifa University Medicine School , Izmir , Turkey ;
Climacteric. 2016 Jun;19(3):308-10. doi: 10.3109/13697137.2015.1117067. Epub 2015 Dec 1.
We describe the first case of mediolateral episiotomic sarcoidosis of the deep vaginal tissue, without involvement of the pulmonary parenchyma or pulmonary symptoms. A 68-year-old female was admitted with a vaginal mass that had developed about 1 month prior. On bimanual examination, we found a painful solid mass approximately 4 cm in diameter on the episiotomy line of the deep vaginal tissue. The patient underwent pelvic magnetic resonance imaging on suspicion of a malignancy, and a vaginal true-cut biopsy was performed. The biopsy specimen exhibited non-caseating, granulomatous inflammation and many multinucleated giant cells, strongly suggesting sarcoidosis. We had excluded other granulomatous diseases; a final diagnosis was made of stage-1 sarcoidosis in the deep vaginal mass. A 3-month course of methotrexate (2.5 mg/week) was commenced to treat a flare-up of rheumatoid arthritis. The vaginal mass resolved. To the best of our knowledge, this is the first case of sarcoidosis in a deep vaginal mass without pulmonary parenchymal or other solid-organ involvement.
我们描述了首例深部阴道组织的会阴侧切术瘢痕结节病病例，未累及肺实质或出现肺部症状。一名68岁女性因约1个月前出现的阴道肿物入院。双合诊检查发现，在深部阴道组织的侧切线上有一个直径约4厘米的压痛性实性肿物。因怀疑为恶性肿瘤，患者接受了盆腔磁共振成像检查，并进行了阴道组织切取活检。活检标本显示为非干酪样肉芽肿性炎症及许多多核巨细胞，强烈提示结节病。我们已排除其他肉芽肿性疾病；最终诊断为深部阴道肿物1期结节病。开始给予甲氨蝶呤（2.5毫克/周）3个月疗程，以治疗类风湿关节炎的 flare-up。阴道肿物消退。据我们所知，这是首例深部阴道肿物的结节病病例，未累及肺实质或其他实体器官。
