Department of Pulmonary and Critical Care Medicine, Institute of Respiratory Health, Center of Precision Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.
BMC Pulm Med. 2024 Oct 9;24(1):497. doi: 10.1186/s12890-024-03316-y.
Although the imaging manifestations of pulmonary sarcoidosis have been described in detail in previous studies, a consensus has not been reached on the imaging presentation of non-specific interstitial pneumonia (NSIP) lookalike pattern as a distinct pattern in the diagnosis of pulmonary sarcoidosis in high-resolution computed tomography (HRCT). No cases of pulmonary sarcoidosis comorbid with NSIP have been reported.
A 53-year-old male presented to the hospital with a five-year history of recurrent coughing up sputum and a four-year history of shortness of breath. In addition to the typical features of pulmonary sarcoidosis, the patient's HRCT also showed unexpected interstitial changes in the lower lobes of both lungs, suggesting an NSIP pattern. Histopathology of the lung tissue in this region confirmed well-formed noncaseating epithelioid granulomas and pathological modifications of NSIP. After a rigorous exclusion diagnosis combining the patient's clinical features, radiological and pathological findings, we diagnosed this patient with pulmonary sarcoidosis comorbid with NSIP.
This suggests that NSIP may act as a rare comorbidity of pulmonary sarcoidosis thereby resulting in the patient's HRCT presenting differently from routine sarcoidosis imaging.
尽管肺结节病的影像学表现已在先前的研究中详细描述，但在高分辨率计算机断层扫描（HRCT）诊断肺结节病时，非特异性间质性肺炎（NSIP）样表现作为一种独特模式的影像学表现尚未达成共识。目前尚未有肺结节病合并 NSIP 的病例报道。
一名 53 岁男性因反复咳痰五年和呼吸困难四年就诊。除了肺结节病的典型特征外，患者的 HRCT 还显示两肺下叶出现意外的间质性改变，提示 NSIP 模式。该区域肺组织的组织病理学证实了形成良好的非干酪样上皮样肉芽肿和 NSIP 的病理改变。在结合患者的临床特征、影像学和病理学发现进行严格排除诊断后，我们诊断该患者患有肺结节病合并 NSIP。
这表明 NSIP 可能作为肺结节病的罕见合并症，导致患者的 HRCT 表现与常规结节病影像学表现不同。
