Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
A Solitary Necrotizing Sarcoid Granulomatosis-like Pulmonary Lesion Possibly Associated with Propionibacterium acnes and Mycobacterium avium
Keigo MurakamiShuko HataNaoya IshibashiMotoki KubotaYoshinobu EishiKeisuke UchidaToshiharu TabataYasuhiro NakamuraKazuhiro Murakami
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JOURNAL OPEN ACCESS

2021 Volume 60 Issue 23 Pages 3773-3778

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Abstract

We report a case of a pulmonary necrotizing sarcoid granulomatosis (NSG)-like lesion possibly associated with coinfection of Mycobacterium avium and Propionibacterium acnes. A solitary nodule in the right middle lobe of the lung was notable for coagulative necrosis with aggregates of sarcoid-like epithelioid granulomas. Small arteries were damaged by granulomas. Both M. avium and P. acnes were detected in the lesion. Furthermore, more P. acnes genomes were detected in the granulomas than in the non-lesion lung. These findings blur the pathophysiologic boundaries among NSG, sarcoidosis, and mycobacteriosis, and suggest that NSG needs to be recognized as continuous spectra of sarcoidosis/mycobcteriosis.

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© 2021 by The Japanese Society of Internal Medicine
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