Implication of Immunohistochemistry for Propionibacterium acnes in Differential Diagnosis of Necrotizing Granuloma
- *Corresponding Author:
- Toshio Suzuki
Department of Respirology, Graduate School of Medicine
Chiba University, 260-8670 1-8-1 Inohana Chuo-ku, Chiba, Japan
E-mail: [email protected] chiba-u.jp
Received date: February 16, 2016; Accepted date: April 14, 2016; Published date: April 18, 2016
Citation: Suzuki T, Fujita A, Takamori M, Murata K, Wada A, et al. (2016) Implication of Immunohistochemistry for Propionibacterium acnes in Differential Diagnosis of Necrotizing Granuloma. J Pulm Respir Med 6:335. doi:10.4172/2161-105X.1000335
Copyright: © 2016 Suzuki T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Propionibacterium acnes (P. acnes) have been reported to have an etiologic link with sarcoidosis. A 45-year-old Japanese woman complaining of cough for 1 month presented to our hospital. Chest computed tomography showed an irregular nodular shadow in the right upper pulmonary lobe, a finding suggestive of either pulmonary sarcoidosis or tuberculosis. Biopsy specimens from the pulmonary shadow showed necrotizing granulomas, and there were no other findings from the initial laboratory examinations that could provide a definitive diagnosis. However, immunohistochemical staining using a P. acnes-specific monoclonal antibody revealed small round bodies within the granulomas. Based on these results, we diagnosed the patient clinically with sarcoidosis, and orally inhaled ciclesonide was administered. At a 7-month follow up, the patient had improved clinically and radiologically. The outcome of this case indicates that immunohistochemical evaluation using a P. acnes antibody may be useful for diagnosing necrotizing granuloma.