Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review
Background: Crohn’s disease and ulcerative hemorrhagic colitis are forms of granulomatous inflammatory intestinal disease, which usually affects the gastrointestinal tract. There are also reported rare localizations at the skin, kidney, joints, liver and eye level. Pulmonary involvement is relativel...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/10/11/2267 |
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| author | Silviu Vlăsceanu Andrei Bobocea Cornel Adrian Petreanu Ioana Anca Bădărău Horațiu Moldovan Daniela Gheorghiță Iulian-Vasile Antoniac Liliana Mirea Camelia Cristina Diaconu Cornel Savu |
| author_facet | Silviu Vlăsceanu Andrei Bobocea Cornel Adrian Petreanu Ioana Anca Bădărău Horațiu Moldovan Daniela Gheorghiță Iulian-Vasile Antoniac Liliana Mirea Camelia Cristina Diaconu Cornel Savu |
| author_sort | Silviu Vlăsceanu |
| collection | DOAJ |
| description | Background: Crohn’s disease and ulcerative hemorrhagic colitis are forms of granulomatous inflammatory intestinal disease, which usually affects the gastrointestinal tract. There are also reported rare localizations at the skin, kidney, joints, liver and eye level. Pulmonary involvement is relatively rare, and it is most commonly reported in suppuration with bronchiectasis. On the other hand, sarcoidosis is, in principle, a thoracic localization of a granulomatosis disease, although bowel, skin and intestinal disorders are described. There is not a clear line to separate Crohn’s disease from sarcoidosis with, possibly because they are, in fact, considered to have the same inflammatory granulomatosis disease pathology. The diagnoses of the two entities, sarcoidosis and Crohn’s disease, are based on non-pathognomonic, inclusive clinical and paraclinical criteria, without elements of the mutual exclusion of typical locations. Case Report: We present a very rare case of a young male, already diagnosed with small-bowel Crohn’s disease. Granulomatous lung disease with major hemoptysis requires emergency surgery. An intraoperative assessment revealed a necrotic hemorrhagic lesion located in the left lower lobe and a lobectomy was performed. The final pathological report showed the presence of non-caseous granulomatous inflammation, with the identification of specific multinucleated giant cells. Conclusions: The identical diagnostic principles of Crohn’s disease and sarcoidosis, Crohn’s disease as a predecessor to pulmonary lesions, the clinical picture and the necrotico-hemorrhagic appearance of the unilateral pulmonary lesion, which are similar to aggressive necrotico-hemorrhagic or perforating intestinal forms, are arguments in favor of the diagnosis of pulmonary Crohn’s disease and not pulmonary sarcoidosis. At the same time, in general, the two diseases have overlapping elements, suggesting they are, in fact, not the same disease with different facets. |
| first_indexed | 2024-03-09T18:18:38Z |
| format | Article |
| id | doaj.art-6b9858f061cc476f8d7619d280bdda6d |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T18:18:38Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-6b9858f061cc476f8d7619d280bdda6d2023-11-24T08:27:53ZengMDPI AGHealthcare2227-90322022-11-011011226710.3390/healthcare10112267Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature ReviewSilviu Vlăsceanu0Andrei Bobocea1Cornel Adrian Petreanu2Ioana Anca Bădărău3Horațiu Moldovan4Daniela Gheorghiță5Iulian-Vasile Antoniac6Liliana Mirea7Camelia Cristina Diaconu8Cornel Savu9Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Materials Science and Engineering, Politehnica University of Bucharest, 060042 Bucharest, RomaniaAcademy of Romanian Scientists, 050045 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaBackground: Crohn’s disease and ulcerative hemorrhagic colitis are forms of granulomatous inflammatory intestinal disease, which usually affects the gastrointestinal tract. There are also reported rare localizations at the skin, kidney, joints, liver and eye level. Pulmonary involvement is relatively rare, and it is most commonly reported in suppuration with bronchiectasis. On the other hand, sarcoidosis is, in principle, a thoracic localization of a granulomatosis disease, although bowel, skin and intestinal disorders are described. There is not a clear line to separate Crohn’s disease from sarcoidosis with, possibly because they are, in fact, considered to have the same inflammatory granulomatosis disease pathology. The diagnoses of the two entities, sarcoidosis and Crohn’s disease, are based on non-pathognomonic, inclusive clinical and paraclinical criteria, without elements of the mutual exclusion of typical locations. Case Report: We present a very rare case of a young male, already diagnosed with small-bowel Crohn’s disease. Granulomatous lung disease with major hemoptysis requires emergency surgery. An intraoperative assessment revealed a necrotic hemorrhagic lesion located in the left lower lobe and a lobectomy was performed. The final pathological report showed the presence of non-caseous granulomatous inflammation, with the identification of specific multinucleated giant cells. Conclusions: The identical diagnostic principles of Crohn’s disease and sarcoidosis, Crohn’s disease as a predecessor to pulmonary lesions, the clinical picture and the necrotico-hemorrhagic appearance of the unilateral pulmonary lesion, which are similar to aggressive necrotico-hemorrhagic or perforating intestinal forms, are arguments in favor of the diagnosis of pulmonary Crohn’s disease and not pulmonary sarcoidosis. At the same time, in general, the two diseases have overlapping elements, suggesting they are, in fact, not the same disease with different facets.https://www.mdpi.com/2227-9032/10/11/2267Crohn’s pulmonarysarcoidosisgranulomatous inflammatory diseaseextraintestinal manifestation |
| spellingShingle | Silviu Vlăsceanu Andrei Bobocea Cornel Adrian Petreanu Ioana Anca Bădărău Horațiu Moldovan Daniela Gheorghiță Iulian-Vasile Antoniac Liliana Mirea Camelia Cristina Diaconu Cornel Savu Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review Healthcare Crohn’s pulmonary sarcoidosis granulomatous inflammatory disease extraintestinal manifestation |
| title | Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review |
| title_full | Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review |
| title_fullStr | Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review |
| title_full_unstemmed | Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review |
| title_short | Pulmonary Crohn’s Disease or Crohn’s Disease with Lung Sarcoidosis? A Case Report and Literature Review |
| title_sort | pulmonary crohn s disease or crohn s disease with lung sarcoidosis a case report and literature review |
| topic | Crohn’s pulmonary sarcoidosis granulomatous inflammatory disease extraintestinal manifestation |
| url | https://www.mdpi.com/2227-9032/10/11/2267 |
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