silicon and Sarcoidosis

A 44-year-old woman was admitted to hospital with end-stage renal failure, productive cough, and decreased exercise tolerance. She had owned nine cats, which resulted in long-term exposure (18 years) to silica-containing bentonite cat litter. High-resolution computed tomography of the chest showed micronodular lesions in the lungs, and mild mediastinal lymphadenopathy. A lung biopsy revealed multinucleated giant cells, some of which had birefringent material and Schaumann bodies. X-ray photoelectron spectroscopy revealed the presence of silicon in the lung biopsy specimen, as well as in the patient's cat litter. The pulmonary condition was suggestive of sarcoid-like lung disease, rather than silicosis, sarcoidosis, or hypersensitivity pneumonitis, according to the clinicopathological findings. Renal failure appeared to be a result of chronic hypercalcemia due to extrarenal calcitriol overproduction in activated alveolar macrophages. Ultimately, the patient was diagnosed with sarcoid-like lung disease complicated by end-stage renal failure from exposure to bentonite cat litter. Therapy with steroids, in addition to elimination of the bentonite cat litter exposure, resulted in a significant improvement in the health condition. At a follow-up visit after 4 months, an almost complete resolution of the lung lesions and a significant improvement in renal function were observed.

Topics: Bentonite; Calcitriol; Female; Humans; Kidney Failure, Chronic; Lung Diseases; Sarcoidosis; Silicon; Silicon Dioxide; Skin Diseases

To evaluate if the new Discovery Molecular Insights (DMI) PET/CT scanner provides equivalent results compared to the standard of care PET/CT scanners (GE Discovery 600 or GE Discovery 690) used in our clinic and to explore any possible differences in semi-quantitative measurements.. The local Institutional Review Board approved the protocol and written informed consent was obtained from each patient. Between September and November 2016, 50 patients underwent a single 18F-FDG injection and two scans: the clinical standard PET/CT followed immediately by the DMI PET/CT scan. We measured SUVmax and SUVmean of different background organs and up to four lesions per patient from data acquired using both scanners.. DMI PET/CT identified all the 107 lesions detected by standard PET/CT scanners, as well as additional 37 areas of focal increased 18F-FDG uptake. The SUVmax values for all 107 lesions ranged 1.2 to 14.6 (mean ± SD: 2.8 ± 2.8), higher on DMI PET/CT compared with standard of care PET/CT. The mean lesion:aortic arch SUVmax ratio and mean lesion:liver SUVmax ratio were 0.2-15.2 (mean ± SD: 3.2 ± 2.6) and 0.2-8.5 (mean ± SD: 1.9 ± 1.4) respectively, higher on DMI PET/CT than standard PET/CT. These differences were statistically significant (P value < 0.0001) and not correlated to the delay in acquisition of DMI PET data (P < 0.0001).. Our study shows high performance of the new DMI PET/CT scanner. This may have a significant role in diagnosing and staging disease, as well as for assessing and monitoring responses to therapies.

Topics: Adult; Aged; Aged, 80 and over; Aorta; Female; Fluorodeoxyglucose F18; Humans; Kidney Neoplasms; Male; Middle Aged; Optical Devices; Pilot Projects; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Sarcoidosis; Silicon; Tonsillar Neoplasms

Ga citrate is frequently used in the workup of fever of unknown origin. Here, we report a case of avid Ga-citrate in bilateral gluteal regions of a patient with a history of free silicon injection buttock augmentation referred for suspected diagnosis of sarcoidosis. CT findings were equivocal for inflammation/infection in the buttock region, and nuclear scintigraphy allowed for more definitive diagnosis.

Topics: Adult; Buttocks; Citrates; Diagnosis, Differential; Female; Gallium; Granuloma; Humans; Injections, Intramuscular; Radiopharmaceuticals; Sarcoidosis; Silicon

To explore the source of the fine particulate matter (PM(2.5)) in the sarcoidosis granulomatous cell and the relationship between the sarcoidosis and the PM(2.5) in the atmosphere.. Paraffin-embedded tissues of 50 cases of human sarcoidosis biopsy samples, 10 cases of non-sarcoidosis autopsy lung samples, 18 cases of lung tissues (with granulomatous lesions) of rats exposed to PM(2.5) by bronchial infusion, and the free PM(2.5) sample in the atmosphere were collected. The characteristics of tissues above mentioned were observed under the light microscopy, which stained by HE staining and Warthin-Starry silver staining. The characteristics of the PM(2.5) in the four groups were analyzed using confocal Raman microscopy. The component of the PM(2.5) in the sarcoidosis granuloma was analyzed using transmission electron microscope-energy dispersive X-ray detector (TEM-EDX), and the component of the PM(2.5) in the atmosphere was analyzed with X-ray fluorescence separately.. The PM(2.5) in the four groups have the similar Raman spectrum, they share the feature of carbonaceous composition, the element component of PM(2.5) in the human sarcoidosis was the same as PM(2.5) in the atmosphere.. The study provided the further evidence that the PM(2.5) in the sarcoidosis lesion was from PM(2.5) in the atmosphere, and it should be not excepted that sarcoidosis may be a sensitive individual reaction to the PM(2.5) inhaled from the atmosphere.

Topics: Adolescent; Adult; Aged; Air Pollutants; Aluminum; Animals; Carbon; Child; Female; Granuloma; Granuloma, Respiratory Tract; Humans; Lung; Male; Middle Aged; Particle Size; Particulate Matter; Rats; Sarcoidosis; Sarcoidosis, Pulmonary; Silicon; Skin Diseases; Spectrum Analysis, Raman; Young Adult

To investigate if there are dust particles in the cells of granulomas of sarcoidosis and analyze its composition and the possible correlation between the sarcoidosis and the composition of dust particles.. The samples of 50 patients with sarcoidosis and 6 patients with silicosis as control were collected by biopsy and/or autopsy sampling. The pathological varieties of the granulomas and the situation of the dust particles within the cells of granulomas were observed using hematoxylin and eosin staining, Warthin-Starry silver staining, immunohistochemistry staining as well as the transmission electron microscope, and the X-Ray spectrum chemical element analysis in the samples from these two kinds of diseases.. The dust particles containing silicon as the main chemical element were present in epithelioid cells and multinucleate giant cells in all the samples. The quantity of the particles deposited in sarcoidosis was less than that in the silicosis. Moreover, the dust cells were found in the granulomas and the visceral pleural lymphatic vessels in the pleura and the hilar pulmonary lymph nodes in sarcoidosis and silicosis. The pathological varieties of the granulomas in sarcoidosis and silicosis were similar.. There are less silicon dust particles in the cells of granulomas of sarcoidosis than in those of the silicotic nodules, which indicates that the silicon dust particles may be related to the sarcoidosis.

Topics: Adolescent; Adult; Aged; Child; Dust; Female; Granuloma; Humans; Male; Middle Aged; Sarcoidosis; Silicon; Silicosis

The authors review the case of a 30-year old female hair-dresser, into the breasts of whom silicone-gel implants have been implanted for cosmetic reasons. Ten months after the operation Löfgren-syndrome evolved, which improved only temporarily after the removal of the implants. The present symptom-free state, existing for 6 months now, required a 17-month corticoid therapy. The authors share the view that in rare cases silicon-gel implants might induce an autoimmune reaction, which is unforeseeable. When it is rightly presumed that human adjuvant disease or some other specified systemic disease is evolving, it is advisable that the implants should be removed and the patient should be treated with immunological therapy.

Topics: Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents, Non-Steroidal; Autoimmune Diseases; Breast Implantation; Diclofenac; Erythema Nodosum; Female; Funnel Chest; Gels; Humans; Sarcoidosis; Silicon; Syndrome; Treatment Outcome

A case of a 28-year-old woman with infiltration of sarcoidosis scar tissue after blepharoplasty is reported. Nodules developed two times in her right upper eyelid about 1 and 2 years after blepharoplasty of both eyes and they were resected each time, but eruption recurred. Ophthalmic examination revealed aqueous flare and cells, snowball vitreous opacities, and retinal periphlebitis. A chest X-ray disclosed bilateral hilar lymphadenopathy (BHL). Laboratory studies showed an elevation of the serum angiotensin converting enzyme (ACE). Light microscopy revealed epithelioid granuloma with no caseation necrosis in a biopsy specimen, Viewing through polarized light demonstrated crystalline-like foreign bodies with bi-refringence in the epithelioid granuloma. Electron microscopic X-ray microanalysis confirmed these foreign bodies to be composed of Si, Mg, and O. These findings indicate that this skin lesion was caused by an infiltration of sarcoidosis scar tissue.

Topics: Adult; Blepharoplasty; Cicatrix; Electron Probe Microanalysis; Eyelid Diseases; Female; Humans; Magnesium; Oxygen; Sarcoidosis; Silicon; Skin Diseases

A 60-year-old woman had extensive and recurrent foreign-body granulomatous inflammation of her forehead. The granulomata contained double refractile crystalline material. Electron probe roentgenographic microanalysis identified silicon, calcium, aluminum, potassium, and sulphur in the crystalline material. Silicon-rich particles are generally considered exogenous. A diagnosis of sarcoidosis was confirmed by the presence of bilateral hilar and mediastinal lymphadenopathy due to biopsy-proven nodal replacement by noninfectious noncaseating granulomata. We conclude that foreign matter may operate as a nidus for the formation of granuloma in sarcoidosis and that the presence of polarizable matter in a sarcoid granuloma does not rule out sarcoidosis.

Topics: Aluminum; Calcium; Electron Probe Microanalysis; Female; Granuloma, Foreign-Body; Humans; Middle Aged; Potassium; Sarcoidosis; Silicon; Skin Diseases; Sulfur

A 42-year-old man developed a papulonodular exanthema 10 years following an injury from a shell explosion. The differential diagnosis between sarcoid-like, foreign-body granulomas and Boeck's sarcoid was inconclusive by histology, but x-ray spectroanalytic examination revealed silicon particles within the epitheloid cell granulomas.

Topics: Adult; Diagnosis, Differential; Foreign Bodies; Granuloma; Humans; Male; Sarcoidosis; Silicon