Isolated cervical lymph node sarcoidosis presenting in an asymptomatic neck mass: a case report

• Published in: Tuberculosis and respiratory diseases Vol. 75; no. 3; pp. 116 - 119
• Main Authors: Kwon, Yong Shik, Jung, Hye In, Kim, Hyun Jung, Lee, Jin Wook, Choi, Won-Il, Kim, Jin Young, Rho, Byung Hak, Lee, Hye Won, Kwon, Kun Young
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Tuberculosis and Respiratory Diseases 01-09-2013; 대한결핵및호흡기학회
• Subjects: Case Report; 내과학; Immunohistochemistry; Lymphatic Diseases; Neck; Sarcoidosis
• ISSN: 1738-3536; 2005-6184
• DOI: 10.4046/trd.2013.75.3.116

Sarcoidosis, a systemic granulomatous disease of unknown etiology. The presentation of sarcoidal granuloma in neck nodes without typical manifestations of systemic sarcoidosis is difficult to diagnose. We describe the case of a 37-year-old woman with an increasing mass on the right side of neck. The excisional biopsy from the neck mass showed noncaseating epithelioid cell granuloma of the lymph nodes. No evidence of mycobacterial or fungal infection was noted. Thoracic evaluations did not show enlargement of mediastinal lymph nodes or parenchymal abnormalities. Immunohistochemistry showed abundant expression of tumor necrosis factor-α in the granuloma. However, transforming growth factor-β was not expressed, although interleukin-1β was focally expressed. These immunohistochemical findings supported characterization of the granuloma and the diagnosis of sarcoidosis. Sarcoidosis can present with cervical lymph node enlargement without mediastinal or lung abnormality. Immunohistochemistry may support the diagnosis of sarcoidosis and characterization of granuloma.