Plevral Tutulum ile Seyreden Sarkoidoz

Kutbay �z�elik, Hatice; Bayram, Mehmet; B�y�kba��l�, Nur P�nar; Kansu, Abdullah; Akkoyunlu, Muhammed Emin; Sezer, Murat; Karak�se, Fatmanur; Yakar, Fatih; Kart, Levent

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Plevral Tutulum ile Seyreden Sarkoidoz [Respir Case Rep]

Respir Case Rep. 2014; 3(1): 16-19 | DOI: 10.5505/respircase.2014.26349

Plevral Tutulum ile Seyreden Sarkoidoz

Hatice Kutbay �z�elik¹, Mehmet Bayram¹, Nur P�nar B�y�kba��l�², Abdullah Kansu¹, Muhammed Emin Akkoyunlu¹, Murat Sezer¹, Fatmanur Karak�se¹, Fatih Yakar¹, Levent Kart¹
¹Bezmialem Vak�f �niversitesi G��s Hastal�klar� Anabilim Dal�
²Bezmialem Vak�f �niversitesi Patoloji Anabilim Dal�

Sarkoidoz, nedeni bilinmeyen, en s�k akci�erleri ve intratorasik lenf nodlar�n� tutan, multisistemik, nonkazeifiye gran�lomat�z bir hastal�kt�r. Literat�rde plevra s�v�s� g�r�lme s�kl�� %0-5 aras�nda bildirilmektedir. Tan� plevra biyopsisinde kazeifikasyon nekrozu i�ermeyen gran�lom g�sterilmesi ve gran�lom yapan di�er nedenlerin d��lanmas� ile konulur. Kuru �ks�r�k ve sol yan a�r�s� �ikayeti ile poliklini�e ba�vuran 26 ya��nda erkek hastan�n fizik muayenesinde sol hemitoraksta solunum seslerinde azalma d��nda di�er sistem muayenelerinde �zellik yoktu. Akci�er grafisinde; bilateral hiler geni�leme, solda plevral ef�zyon ve sol �st zonda nonhomojen dansite art�� tespit edildi. Bronkoskopiyi tolere edemeyen hastaya video yard�ml� torakoskopi (VATS ) uyguland�. Plevra ve mediastinal lenf bezi �rnekleri histopatolojisi nekrozla�mayan gran�lomat�z iltihap, sarkoidoz ile uyumlu olarak raporland�. Metilprednisolon (0.5 mg /kg /g�n) ba�lanan hastan�n akci�er grafisindeki lezyonlarda regresyon tespit edildi. Pl�rezi tespit etti�imiz hastalarda, t�berk�loz insidansi y�ksek olan yerlerde bile sarkoidozun akla gelmesi a��s�ndan bu olguyu sunmay� uygun bulduk.

Anahtar Kelimeler: sarkoidoz, plevral ef�zyon, video yard�ml� torakoskopi

Sarcoidosis Presenting with Pleural Involvement

Hatice Kutbay �z�elik¹, Mehmet Bayram¹, Nur P�nar B�y�kba��l�², Abdullah Kansu¹, Muhammed Emin Akkoyunlu¹, Murat Sezer¹, Fatmanur Karak�se¹, Fatih Yakar¹, Levent Kart¹
¹Bezmialem Vak�f University Department Of Chest Deseases
²Bezmialem Vak�f University Department Of Patology

Sarcoidosis is a multisystemic, granulomatous disease with particular involvement in the lungs and intrathoracic lymph nodes. The prevalence of pleural fluid occurs in 0-5% of the cases in the literature. Diagnosis depends on non-caseating granulomas in the biopsy and the exclusion of other possible reasons. A 26-year-old male admitted with cough and left sided chest pain. Physical examination was normal except a decrease in respiratory sounds in the left hemithorax. The chest x-ray showed bilateral hilar enlargement, pleural fluid in the left hemithorax, and non-homogenous density in the left upper zone. Video-assisted thoracosopic surgery (VATS) was performed because the patient could not tolerate bronchoscopy. The histopathological examination of samples reported non-necrotizing granulomatous inflammation. Methylprednisolone (0.5 mg/kg/day) was initiated. Regression of lymphadenopathies, pleural effusion, and parenchymal opacities were present at the fifth month of therapy. This case emphasizes the possibility of sarcoidosis in patients with pleural effusion, even in places where tuberculosis prevalence is high.

Keywords: sarcoidosis, pleural effusion, video-assisted thoracoscopy

Sorumlu Yazar: Hatice Kutbay �z�elik, T�rkiye
Makale Dili: �ngilizce

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