Chest
Clinical Investigations: Granulomatous DiseaseNecrotizing Sarcoid Granulomatosis With Pleural Involvement: Clinical and Radiographic Features
Section snippets
Materials and Methods
We report on seven patients with NSG who presented to the Division of Respirology at the University of Western Ontario from 1988 to 1992. The cases were identified through a retrospective chart review. All patients underwent open lung and/or mediastinal lymph node biopsy for diagnosis. The histologic criteria of Liebow1 were used for inclusion. Briefly, these include sarcoid-like granulomata undergoing necrosis, possibly associated with a vasculitis of granulomatous, giant cell, or lymphocytic
Results
All patients were well and were receiving no medication prior to presentation. The population consisted of five women and two men ranging in age from 24 to 57 years with a mean age of 36 years. Patient 1 represented the only smoker in the group. All patients presented for evaluation of dyspnea, fever, nonproductive cough, weight loss, and night sweats. Six of seven patients also complained of pleuritic chest pain. The duration of symptoms prior to presentation ranged from 2 to 6 months. Patient
Discussion
In the original description of NSG, Liebow1 reported on 11 patients. Since that time, an additional 75 cases have been described.2, 3, 4, 5, 6, 7, 8, 9 Patients tend to be young to middle aged with a female predominance. Symptoms are nonspecific but frequently are a combination of cough, fever, malaise, and dyspnea. A minority of patients are asymptomatic. Our patients were similar, showing a female preponderance, but with pleuritic chest pain as a major component of their clinical presentation.
ACKNOWLEDGMENT
The authors wish to thank Dr. R. Inculet for providing data on two of the patients enrolled in the study, and Sandra Reiehstein for her help in preparing the manuscript.
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