Muscle involvement in sarcoidosis

A 31-year-old man presented with dry cough of 2 months duration. He was detected to have mediastinal adenopathy, raised serum calcium and ACE levels. He underwent endoscopic ultrasound-guided biopsy from subcarinal and peripancreatic nodes, which showed discrete non-caseating granulomas. A diagnosis of sarcoidosis was made and he underwent a whole-body fluorodeoxyglucose-positron emission tomography (FDG PET) scan to assess disease activity elsewhere. It revealed the presence of FDG avid right cervical, mediastinal and retroperitoneal lymphadenopathy (figure 1 green arrows). Poorly defined hypoenhancing multiple intramuscular nodular lesions with spotty intense FDG uptake were also noted (figure 1 blue arrow and figure 2 white arrow). Skeletal muscle involvement occurs subclinically in as high as 50% to 80% of individuals with sarcoidosis but is very infrequently (0.5% to 2.5%) symptomatic.1 18F-FDG-PET scans can identify active sarcoid. The findings include a patchy pickup in the skeletal muscle,...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Images Source Type: research