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Journal of Ophthalmology
Volume 2014 (2014), Article ID 656042, 3 pages
http://dx.doi.org/10.1155/2014/656042
Review Article

Solitary Sarcoid Granuloma of the Iris Mimicking Tuberculosis: A Case Report

1Department of General Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
2Medical Research Center of the Polish Academy of Sciences, 02-106 Warsaw, Poland
3Department of Ophthalmology, University of Erlangen-Nürnberg, 91054 Erlangen, Germany
4Department of Ophthalmology, F. Chopin Specialist District Hospital in Rzeszów, 35-055 Rzeszów, Poland

Received 1 November 2013; Accepted 5 February 2014; Published 10 March 2014

Academic Editor: Edward Manche

Copyright © 2014 Robert Rejdak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. We report a case of a male patient presented with sarcoid lesions of the iris and conjunctiva, mimicking tuberculosis due to epithelioid cell granulomas with small central necrosis in conjunctival biopsy. Patient. A 25-year-old man was referred to our department for further management of an “iris tumor with iridocyclitis” in his right eye. Initial examination showed an isolated vascular tumor of the iris and ciliary body with anterior uveitis and mutton-fat keratic precipitates, suggesting the diagnosis of a granulomatous disease. Conjunctival biopsy revealed granulomatous epithelioid cell inflammation with small central necrosis without acid-fast bacilli. Extensive systemic examination, including bronchoscopy and transbronchial biopsy, provided the diagnosis of sarcoidosis stage 2 with pulmonary involvement, thus ruling out tuberculosis. Systemic and local steroid therapy was initiated, leading to complete recovery of our patient with complete disappearance of the iris lesion and improvement of the pulmonary function. Conclusion. Although noncaseating epithelioid cell granulomas are typical for sarcoidosis, small central necrosis can be found in some granulomas, leading to presumption of tuberculosis. Extensive systemic checkup in cooperation with other specialists is essential to confirm the correct diagnosis and to initiate the appropriate therapy.