Sarcoidosis Manifesting as a Pseudotumorous Renal Mass

A 53 year-old African American woman with a three-year history of pulmonary sarcoidosis had a follow-up computed tomographic scan to evaluate the status of her disease and response to treatment. On the scan, an abnormal, hypodense mass on the left renal superior pole, which was not present on previous scans, was incidentally discovered. The initial concern was of carcinoma, despite her lack of any urinary symptoms. She underwent further evaluation with magnetic resonance, and the enhancement pattern and the shape of the mass were more suggestive of lymphoma or infarction than a carcinoma. A review of literature revealed sparse case reports demonstrating sarcoidosis presenting as infiltrative granulomatous masses resembling tumors with nonspecific imaging qualities. This diagnosis was entertained and then proven by biopsy. Pseudotumorous renal sarcoid should be in the differential of renal masses, especially in patients with a history of sarcoidosis, as it alters clinical management.
Source: Journal of Radiology Case Reports - Category: Radiology Source Type: research

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Poshmaal Dhar1 and Julie McAuley2* 1Faculty of Health, School of Medicine, Deakin University, Geelong, VIC, Australia 2Department of Microbiology and Immunology, Peter Doherty Institute, University of Melbourne, Melbourne, VIC, Australia The family of cell surface (cs-) mucins are constitutively expressed at the cell surface by nearly all epithelial cells, beneath the gel-mucin layer. All cs-mucin family members have structural features that enable them to act as a releasable decoy barrier to mucosal pathogens, by providing ligands for pathogen binding and the ability to shed the bound extracellular domain. Due ...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Publication date: Available online 15 April 2019Source: Respiratory Medicine Case ReportsAuthor(s): Asma Iftikhar, Muhammad A.I. Cheema, Preethi Ramachandran, Sonu SahniAbstractRenal cell carcinoma (RCC) is a highly vascular tumor, which may spread to the lungs and other organs. It often presents with localized or systemic manifestation, including paraneoplastic syndromes. Sarcoidosis is a systemic granulomatous inflammatory disease characterized by non-caseating granulomas that typically afflicts the respiratory system. In the absence of any evidence of systemic sarcoidosis they are referred to as sarcoid-like reactions. ...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
A 60-year-old multi-morbid male patient with polycystic kidney disease and secondary chronic renal insufficiency stage G5 A3 according to Kidney Disease: Improving Global Outcomes (KDIGO) classification was referred to our hospital with radiological differential diagnoses of sarcoidosis, ectasia of the pulmonary arteries, lymphoma, or central bronchial carcinoma with contralateral hilar lymph node metastases. He had concomitant arterial hypertension, manifest osteoporosis due to renal osteopathy, secondary compensated renal hyperparathyroidism, compensated metabolic renal acidosis, and diabetes mellitus type 2.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Image Source Type: research
Conclusion: Awake EUS-B is a safe, well tolerated procedure that can be done without sedation in patients with high risk for sedation.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Conclusion EBUS-TBNA with a 19-G needle was useful for diagnosing retinal hemangioblastoma and tuberculous lymphadenitis as well as for PD-L1 testing after 21- and 22-G biopsies were unsuccessful. PMID: 30146572 [PubMed - as supplied by publisher]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Introduction: Binding of programmed cell death 1 (PD-1) ligands to PD-1 receptors found on T cells, inhibits T-cell proliferation and contributes to immune tolerance and inhibition of tumor surveillance. Nivolumab is a monoclonal antibody that binds to PD-1 receptor and inhibits this pathway. Given its antitumor capabilities, this medication was recently approved in Canada and the U.S. for the treatment of unresectable or metastatic melanoma, metastatic nonsmall cell lung cancer, renal carcinoma, and classical Hodgkin lymphoma.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
In January, 2018, Academic Press published my bookPrecision Medicine and the Reinvention of Human Disease. This book has an excellent " look inside " at itsGoogle book site, which includes the Table of Contents. In addition, I thought it might be helpful to see the topics listed in the Book's index. Note that page numbers followed by f indicate figures, t indicate tables, and ge indicate glossary terms.AAbandonware, 270, 310geAb initio, 34, 48ge, 108geABL (abelson leukemia) gene, 28, 58ge, 95 –97Absidia corymbifera, 218Acanthameoba, 213Acanthosis nigricans, 144geAchondroplasia, 74, 143ge, 354geAcne, 54ge, 1...
Source: Specified Life - Category: Information Technology Tags: index jules berman jules j berman precision medicine Source Type: blogs
Discussionby Dr MGK Murthy, Dr GA PrasadChronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is characterized clinically by a progressive or relapsing course of many months to years of symptoms similar to compressive myelopathy.Etiology Remains unknown, but T-cell activation in nerves plays an important role in the pathogenesis of CIDP&antigens in Schwann cells have been identified.PathologicallyCIDP is characterized by mononuclear cell infiltrates, edema, segmental demyelination, and remyelination&“onion bulb formation” which describes enlarged fascicles with increased endoneural connectiv...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs
Conclusions: Preliminary results obtained with the dedicated Flex 19G needle are promising, as sample size/quality is satisfactory and the needle influence on scope flexibility is minimal. This article is protected by copyright. All rights reserved.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
Conclusion: For evaluation of indeterminate lymphadenopathy in this population, FDG PET/CT had very poor PPV (i.e., frequent false positive results with benign / inflammatory etiologies, as would be expected) but had very high NPV of 97%. Such strong NPV renders malignancy very unlikely in cases where FDG PET is negative (representing 33% of patients in this cohort), which may allow for more confident observation of FDG-negative cases thus potentially avoiding costly and invasive procedures such as EBUS, mediastinoscopy or CT-guided biopsies, especially in elderly patients. Research Support: N/A
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Lymphoma - Adult Source Type: research
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