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Implication of Immunohistochemistry for Propionibacterium acnes in Differential Diagnosis of Necrotizing Granuloma | OMICS International | Abstract
ISSN: 2161-105X

Journal of Pulmonary & Respiratory Medicine
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Case Report

Implication of Immunohistochemistry for Propionibacterium acnes in Differential Diagnosis of Necrotizing Granuloma

Toshio Suzuki1*, Akira Fujita2, Mikio Takamori3, Kengo Murata3, Akihiko Wada3, Maki Miyamoto3, Yuki Yamamoto4, Kentaro Sakashita3, Yuji Tada1, Yoshimi Suzuki5, Yoshinobu Eishi5 and Koichiro Tatsumi1

1Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan

2Department of Internal Medicine, Tama-Nambu Chiiki Hospital, Tokyo, Japan

3Department of Pulmonary Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan

4Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

5Department of Human Pathology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan

*Corresponding Author:
Toshio Suzuki
Department of Respirology, Graduate School of Medicine
Chiba University, 260-8670 1-8-1 Inohana Chuo-ku, Chiba, Japan
Tel: +81-43-222-7171
Fax: +81-43-226-2176
E-mail: [email protected]

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.