Masuda Yuiko, Okabayashi Hiroko, Akaike Kimitaka, Hamada Shohei, Masunaga Aiko, Ichiyasu Hidenori, Ohashi Kenichi, Sakagami Takuro
Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life, Sciences, Kumamoto University, Kumamoto, Japan.
Department of Human Pathology, Institute of Science Tokyo, Tokyo, Japan.
Front Med (Lausanne). 2025 Mar 19;12:1552114. doi: 10.3389/fmed.2025.1552114. eCollection 2025.
Tattoo sarcoidosis is characterized by a granulomatous reaction localized to the tattoo site and typical systemic symptoms of sarcoidosis. Herein, we report the case of a patient diagnosed with tattoo sarcoidosis.
A 28-year-old man presented with subcutaneous nodules at two tattoo sites, bilateral hilar and mediastinal lymphadenopathy, multiple micronodules predominantly in the upper lobes of both lungs, elevated serum angiotensin-converting enzyme and soluble interleukin-2 receptor levels, hypercalcemia, and renal dysfunction. Skin biopsy of a subcutaneous nodule revealed epithelioid cell granulomas. Although periodic acid-Schiff, Grocott methenamine silver, and acid-fast staining showed negative results, antibody staining for within the epithelioid cell granuloma was positive. Remarkably, all lesions spontaneously resolved, and the systemic manifestations also improved without medical treatment.
The pathogenesis of tattoo sarcoidosis remains unknown, although an immune response to tattoo pigments has been suspected. However, there is a theory that is the causative agent of sarcoidosis. In the present case, the detection of within the epithelioid cell granuloma suggests that the bacterium may play a role in the etiology of tattoo sarcoidosis.
纹身结节病的特征是局限于纹身部位的肉芽肿反应以及结节病的典型全身症状。在此，我们报告一例被诊断为纹身结节病的患者病例。
一名28岁男性在两个纹身部位出现皮下结节，双侧肺门及纵隔淋巴结肿大，双肺上叶多发微小结节，血清血管紧张素转换酶和可溶性白细胞介素-2受体水平升高，高钙血症及肾功能不全。对一个皮下结节进行皮肤活检显示上皮样细胞肉芽肿。尽管过碘酸希夫染色、格罗科特六胺银染色及抗酸染色结果均为阴性，但上皮样细胞肉芽肿内的抗体染色呈阳性。值得注意的是，所有病变均自发消退，全身表现未经治疗也有所改善。
尽管怀疑对纹身颜料存在免疫反应，但纹身结节病的发病机制仍不清楚。然而，有一种理论认为某病原体是结节病的致病因子。在本病例中，在上皮样细胞肉芽肿内检测到该病原体提示其可能在纹身结节病的病因中起作用。
