• Internal medicine · Dec 2021

    Case Reports

    A Solitary Necrotizing Sarcoid Granulomatosis-like Pulmonary Lesion Possibly Associated with Propionibacterium Acnes and Mycobacterium Avium.

    • Keigo Murakami, Shuko Hata, Naoya Ishibashi, Motoki Kubota, Yoshinobu Eishi, Keisuke Uchida, Toshiharu Tabata, Yasuhiro Nakamura, and Kazuhiro Murakami.
    • Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan.
    • Intern. Med. 2021 Dec 1; 60 (23): 3773-3778.

    AbstractWe 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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