Diagnosis of uveo-parotid fever by 67Ga-citrate imaging

Sarcoidosis diagnosed on fine-needle aspiration cytology of salivary glands: a report of three cases

Three female patients, two presenting with bilateral parotid gland enlargement and one with bilateral submandibular gland enlargement, were subjected to fine-needle aspiration cytology (FNAC). Smears showed noncaseating epithelioid cell granulomas with or without giant cells and salivary gland acini with varying degrees of degenerative changes. After excluding other granulomatous lesions, sarcoidosis was suggested and was subsequently proved in all three cases. FNAC, therefore, may be considered a useful diagnostic modality in cases of sarcoidosis presenting primarily with head and neck involvement.

Parotid gland biopsy and 67Ga imaging correlation in systemic sarcoidosis

We correlated the results of parotid gland biopsy, chest roentgenograms, and gallium citrate scintigraphy in 24 patients evaluated for possible systemic sarcoidosis. Of 19 patients ultimately proven to have sarcoidosis, 11 (57.9 percent) had positive parotid gland biopsy. The yield of parotid gland biopsy in patients with abnormal gallium parotid activity was only marginally higher (64.7 percent). Abnormal parotid gland uptake of gallium citrate was seen in 17 of these 19 patients (89.5 percent) and was always associated with abnormal lung or perihilar activity. The parotid gland biopsy is a useful technique for obtaining the tissue diagnosis of sarcoidosis; however, gallium scintigraphy should not be performed to select patients as this will only marginally increase the biopsy yield.

Laboratory diagnosis of ophthalmic sarcoidosis

Because the eye is involved in about 25% of patients with active sarcoid, the ophthalmologist is often the first physician to see these patients. Although clinical findings may suggest sarcoid, laboratory tests (e.g., x-ray, skin tests, blood chemistries, etc.) may be normal or inconclusive. Thus, it is important that the ophthalmologist be aware of the availability and limitations of the various biochemical, immunological, radiological, and histopathological tests that contribute to the early diagnosis of sarcoidosis. The authors review diagnostic procedures and present a flowchart detailing indications for each.

Limited gallium scans and angiotensin converting enzyme in granulomatous uveitis

The use of serum angiotensin converting enzyme (ACE) and limited gallium scans of the head, neck, and chest for patients with granulomatous uveitis is described. Mean serum ACE activity was elevated in patients with granulomatous uveitis regardless of the presence of systemic sarcoidosis. Furthermore, pathologic gallium uptake was noted in lacrimal glands, parotid glands, and lungs in some cases. These results indicate that sarcoidosis may be more common than previously believed in these patients.