case_images: PMC5420916_01
case_images: Chest computed tomography (CT) scan showing increased bilateral interstitial lung markings with bilateral hilar and mediastinal lymphadenopathy most consistent with stage IV sarcoidosis.
case_images: CRIRH2017-8469629.001.jpg
case_images: PMC5420916_01_CRIRH2017-8469629.001.jpg
case_images: fig1
case_images: A chest computed tomography (CT) scan was performed and revealed increased bilateral interstitial lung markings with bilateral hilar and mediastinal lymphadenopathy most consistent with stage IV sarcoidosis (Figure 1).
case_images: Transbronchial lung biopsy showing nonnecrotizing granulomatous inflammation with multinucleated giant cells (arrow).
case_images: CRIRH2017-8469629.002.jpg
case_images: PMC5420916_01_CRIRH2017-8469629.002.jpg
case_images: fig2
case_images: Bronchoscopy with transbronchial lung biopsy was performed and pathology revealed nonnecrotizing granulomatous inflammation (Figure 2).
case_images: H & E stain of quadriceps muscle biopsy showing muscle atrophy (white arrows) and inflammatory cell infiltrate (black arrow).
case_images: CRIRH2017-8469629.003.jpg
case_images: PMC5420916_01_CRIRH2017-8469629.003.jpg
case_images: fig3
case_images: A quadriceps muscle biopsy was performed and histopathology showed basophilic atrophic nonnecrotic myofibers in clusters with rare rimmed vacuoles, enlarged reactive myonuclei, with endomysial and perivascular infiltrates of chronic inflammatory cells (Figures 3 and 4).
case_images: Gomori Trichrome stain of quadriceps muscle biopsy showing "rimmed vacuole" (red arrows) in a center of the myofiber, a classic feature of IBM.
case_images: CRIRH2017-8469629.004.jpg
case_images: PMC5420916_01_CRIRH2017-8469629.004.jpg
case_images: fig4
case_images: A quadriceps muscle biopsy was performed and histopathology showed basophilic atrophic nonnecrotic myofibers in clusters with rare rimmed vacuoles, enlarged reactive myonuclei, with endomysial and perivascular infiltrates of chronic inflammatory cells (Figures 3 and 4).