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颞骨原发性结节病:临床与病理对照

Primary Sarcoidosis of the Temporal Bone a Clinical Pathologic Correlation.

作者信息

Fallon Keelin, Akalin Ali, Wu Peggy, Remenschneider Aaron K

机构信息

UMass Chan Medical School, Worcester, MA.

Department of Pathology, UMass Chan Medical School, Worcester, MA.

出版信息

Otol Neurotol Open. 2023 Sep 12;3(3):e039. doi: 10.1097/ONO.0000000000000039. eCollection 2023 Sep.

Abstract

OBJECTIVE

This report describes a case of sarcoidosis that presented as a lytic bone lesion in the squamous part of the temporal bone.

PATIENTS

A 64-year-old woman presented with right-sided aural fullness, pulsatile tinnitus, and intermittent otalgia.

INTERVENTIONS

CT and MRI were performed without contrast and suggested an osseodestructive, lytic bone lesion. An excisional biopsy was performed, showing granulomatous infiltration suggestive of osseous sarcoidosis.

MAIN OUTCOME MEASURES

Removal of mass and resolution of symptoms.

RESULTS

Initial findings from patient imaging suggested a lytic bone lesion. An excisional biopsy was required for diagnosis and was performed with little patient morbidity. Biopsy findings showed granulomatous infiltration suggestive of osseous sarcoidosis. Osseous involvement of sarcoidosis is a rare manifestation and typically occurs secondary to other disease manifestations. After the removal of the mass and a short unrelated course of steroids, the patient's symptoms resolved.

CONCLUSIONS

Sarcoidosis should be added to the differential diagnosis of lytic bone lesions in the temporal bone.

摘要

目的

本报告描述了一例结节病,其表现为颞骨鳞状部的溶骨性骨病变。

患者

一名64岁女性,出现右侧耳部胀满、搏动性耳鸣和间歇性耳痛。

干预措施

进行了无对比剂的CT和MRI检查,提示存在骨质破坏的溶骨性骨病变。进行了切除活检,显示肉芽肿浸润,提示骨结节病。

主要观察指标

肿物切除及症状缓解。

结果

患者影像学的初步检查结果提示溶骨性骨病变。诊断需要进行切除活检,且活检对患者的损伤较小。活检结果显示肉芽肿浸润,提示骨结节病。结节病的骨受累是一种罕见表现,通常继发于其他疾病表现。肿物切除及短期使用无关的类固醇药物治疗后,患者症状缓解。

结论

结节病应列入颞骨溶骨性骨病变的鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96e1/10950189/c6c194a7d280/ono-3-e039-g001.jpg

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