Recurrent solitary sarcoidosis in bone--a case report.

In 1991, a 34-year-old Japanese woman presented with gradually increasing pain and swelling of her right middle finger over a 4-month period. Radiographics revealed an osteolytic lesion in the proximal end of the middle phalanx (Figure 1). Routine hematological and serum biochemical examinations were normal, and the patientʼs past medical history was unremarkable. An excisional biopsy and curettage were performed, and showed numerous non-caseating granulomas, typical of sarcoidosis. A retrospective examination of her chest radiograph, a routine procedure before a surgical intervention, showed no evidence of pulmonary involvement by sarcoidosis. However, on careful examination with computed tomography (CT), we found slight bilateral hilar lymph node enlargement suggestive of lung sarcoidosis (Figure 2). Because of the subsequent disappearance of these CT findings, she was not given systemic corticosteroid treatment. After relief of pain for several months, the digital pain and swelling recurred, and became very severe about 1 year after the first Recurrent solitary sarcoidosis in bone—a case report