Nureki Shin-Ichi, Miyazaki Eishi, Yamasue Mari, Takenaka Ryuichi, Ando Masaru, Kadota Jun-Ichi
Department of Respiratory Medicine and Infectious Diseases and.
Center for Community Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan.
Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(4):373-379. doi: 10.36141/svdld.v34i4.5523. Epub 2017 Apr 28.
We report a case of sarcoidosis with concomitant epididymis, testes, and phalanxes involvement mimicking intrascrotal organ cancer and metastatic bony disease. A 23-year-old man developed blurred vision and hyperemia of the left eye, and was diagnosed as having left iritis. A chest computed tomography scan detected bilateral hilar lymphadenopathy and lung nodular shadows. A transbronchial lung biopsy revealed a non-caseating granuloma and he was diagnosed with sarcoidosis. One year after the onset of his eye symptoms, he noticed enlargement of his right scrotum. Magnetic resonance imaging detected lesions of the right epididymis, bilateral testes, and bilateral phalanxes. A technetium-99m scintigram revealed a high accumulation in the bilateral bones of extremities. These radiological findings mimicked intrascrotal organ cancer and metastatic bony disease. Pathologic evaluation following the right epididymectomy revealed non-caseating granulomas compatible with sarcoidosis. Three and half years after the appearance of intrascrotal and bony lesions, they improved spontaneously. .
我们报告一例结节病，同时累及附睾、睾丸和指骨，酷似阴囊内器官癌和转移性骨病。一名23岁男性出现左眼视力模糊和充血，被诊断为左虹膜炎。胸部计算机断层扫描发现双侧肺门淋巴结肿大和肺部结节阴影。经支气管肺活检显示非干酪样肉芽肿，他被诊断为结节病。眼部症状出现一年后，他注意到右侧阴囊肿大。磁共振成像检测到右侧附睾、双侧睾丸和双侧指骨有病变。锝-99m闪烁扫描显示四肢双侧骨骼有高积聚。这些影像学表现酷似阴囊内器官癌和转移性骨病。右侧附睾切除术后的病理评估显示与结节病相符的非干酪样肉芽肿。阴囊和骨病变出现三年半后，它们自发改善。
