Lim Chee Chean, Ghauth Sakina, Liew Yew Toong, Bakar Mohd Zukiflee Bin Abu, Narayanan Prepageran A L
Department of Otorhinolaryngology-Head and Neck Surgery, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Eur Arch Otorhinolaryngol. 2023 Feb;280(2):925-927. doi: 10.1007/s00405-022-07808-7. Epub 2023 Jan 2.
Sarcoidosis is a granulomatous disorder involving multi-systemic organs. Patients invariably have lung involvement but some may have extrapulmonary disease. Rarely, cervical lymphadenopathy is the only sign without mediastinal or pulmonary abnormalities.
We report a Malay male who complained of neck swelling exclusively. On imaging, multiple enlarged cervical lymph nodes deep to the sternocleidomastoid muscle were seen. An excision biopsy revealed non-caseating granulomas with epithelioid macrophages. Extensive investigations led to the diagnosis of isolated cervical lymph node sarcoidosis.
Sarcoidosis can present as cervical lymphadenopathy alone, without mediastinal or lung disease. The presence of epithelioid granulomas on histopathology warrants the exclusion of other granulomatous diseases. Isolated cervical lymph node sarcoidosis is only diagnosed in the presence of consistent clinical and radiological findings. In this case, close monitoring for systemic sarcoidosis is important as it can manifest later in life.
结节病是一种累及多系统器官的肉芽肿性疾病。患者均有肺部受累，但部分患者可能有肺外疾病。极少数情况下，颈部淋巴结病是唯一体征，而无纵隔或肺部异常。
我们报告一名马来男性，仅主诉颈部肿胀。影像学检查显示胸锁乳突肌深部有多个肿大的颈部淋巴结。切除活检显示非干酪样肉芽肿及上皮样巨噬细胞。广泛检查后诊断为孤立性颈部淋巴结结节病。
结节病可仅表现为颈部淋巴结病，而无纵隔或肺部疾病。组织病理学上出现上皮样肉芽肿需要排除其他肉芽肿性疾病。孤立性颈部淋巴结结节病只有在有一致的临床和影像学表现时才能诊断。在这种情况下，密切监测全身性结节病很重要，因为它可能在以后的生活中出现。
