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Challenges in Diagnosing Necrotizing Sarcoid Granulomatosis: The First Case Reported From Indonesia
Gurmeet Singh1,2, Ramadhan Karsono2,3, Soedarman Sjamsoe4
1Division of Respirology and Critical Illness, Universitas Indonesia Departemen Ilmu Penyakit Dalam, Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta, Indonesia.
Case Reports in Medicine
|April 22, 2025
Summary
Necrotizing sarcoid granulomatosis (NSG) is a rare condition affecting the lungs. Early diagnosis and corticosteroid treatment, as shown in this case, can lead to positive outcomes.
Area of Science:
- Medicine
- Pathology
- Immunology
Background:
- Necrotizing sarcoid granulomatosis (NSG) is an uncommon inflammatory disorder.
- It presents with granulomatous, necrotic, and vasculitic features, primarily affecting the lungs.
Observation:
- A 71-year-old male experienced prolonged fever, a neck mass, and mediastinal lymphadenopathy.
- Initial suspicion of pulmonary tuberculosis was ruled out by biopsy.
- A thyroid lobe biopsy confirmed the NSG pattern.
Findings:
- Surgical biopsy is crucial for diagnosing NSG, especially with extrapulmonary involvement.
- Oral prednisolone treatment resulted in significant radiological improvement within 3 months.
Implications:
- This case highlights diagnostic challenges in rare diseases like NSG.
- Increased clinician awareness is vital for timely and accurate NSG diagnosis and management.
