Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report

Introduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy. Patient. A 25-year-old man was referred to our department for further management...

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Main Authors: Robert Rejdak, Pavel Pogorelov, Christian Y. Mardin, Małgorzata Szkaradek, Anselm G. M. Juenemann
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2014/656042
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author Robert Rejdak
Pavel Pogorelov
Christian Y. Mardin
Małgorzata Szkaradek
Anselm G. M. Juenemann
author_facet Robert Rejdak
Pavel Pogorelov
Christian Y. Mardin
Małgorzata Szkaradek
Anselm G. M. Juenemann
author_sort Robert Rejdak
collection DOAJ
description Introduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy. Patient. A 25-year-old man was referred to our department for further management of an “iris tumor with iridocyclitis” in his right eye. Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates, suggesting the diagnosis of a granulomatous disease. Conjunctival biopsy revealed granulomatous epithelioid cell inflammation with small central necrosis without acid-fast bacilli. Extensive systemic examination, including bronchoscopy and transbronchial biopsy, provided the diagnosis of sarcoidosis stage 2 with pulmonary involvement, thus ruling out tuberculosis. Systemic and local steroid therapy was initiated, leading to complete recovery of our patient with complete disappearance of the iris lesion and improvement of the pulmonary function. Conclusion. Although noncaseating epithelioid cell granulomas are typical for sarcoidosis, small central necrosis can be found in some granulomas, leading to presumption of tuberculosis. Extensive systemic checkup in cooperation with other specialists is essential to confirm the correct diagnosis and to initiate the appropriate therapy.
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spelling doaj-art-15ddc38e92854ac4b76ca07a4c1450522025-02-03T01:13:04ZengWileyJournal of Ophthalmology2090-004X2090-00582014-01-01201410.1155/2014/656042656042Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case ReportRobert Rejdak0Pavel Pogorelov1Christian Y. Mardin2Małgorzata Szkaradek3Anselm G. M. Juenemann4Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, PolandDepartment of Ophthalmology, University of Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Ophthalmology, University of Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, PolandDepartment of Ophthalmology, University of Erlangen-Nürnberg, 91054 Erlangen, GermanyIntroduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy. Patient. A 25-year-old man was referred to our department for further management of an “iris tumor with iridocyclitis” in his right eye. Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates, suggesting the diagnosis of a granulomatous disease. Conjunctival biopsy revealed granulomatous epithelioid cell inflammation with small central necrosis without acid-fast bacilli. Extensive systemic examination, including bronchoscopy and transbronchial biopsy, provided the diagnosis of sarcoidosis stage 2 with pulmonary involvement, thus ruling out tuberculosis. Systemic and local steroid therapy was initiated, leading to complete recovery of our patient with complete disappearance of the iris lesion and improvement of the pulmonary function. Conclusion. Although noncaseating epithelioid cell granulomas are typical for sarcoidosis, small central necrosis can be found in some granulomas, leading to presumption of tuberculosis. Extensive systemic checkup in cooperation with other specialists is essential to confirm the correct diagnosis and to initiate the appropriate therapy.http://dx.doi.org/10.1155/2014/656042
spellingShingle Robert Rejdak
Pavel Pogorelov
Christian Y. Mardin
Małgorzata Szkaradek
Anselm G. M. Juenemann
Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report
Journal of Ophthalmology
title Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report
title_full Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report
title_fullStr Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report
title_full_unstemmed Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report
title_short Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report
title_sort solitary sarcoid granuloma of the iris mimicking tuberculosis a case report
url http://dx.doi.org/10.1155/2014/656042
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AT małgorzataszkaradek solitarysarcoidgranulomaoftheirismimickingtuberculosisacasereport
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