PMC5088489_01
OD fundus. a Initial visit: optic disc hyperemia and edema and several yellowish subretinal lesions located in the posterior pole and lower midperiphery. b After 6-month therapy: decreased optic disc hyperemia and edema and increased choroidal granulomas. c After 18-month therapy: decreased choroidal granulomas
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Fig1
Fundoscopy disclosed mild swollen and hyperemic optic discs and some subretinal yellowish nodules of 1/3 to 1 disc diameter, partially delimited, located in the posterior pole and midperiphery in both eyes (Figs. 1a and 2a).   Six months after the treatment began the prednisone intake was 20 mg/day, when there was a decrease in papillitis and an increase in the choroidal granuloma size (Figs. 1b and 2b). By the 18th month of treatment the intake of prednisone was 10 mg/day, leading to a gradual reduction in the choroidal granulomas' size and thickness and stabilized uncorrected visual acuity of 20/20 in both eyes (Figs. 1c and 2c).
OS fundus. a Initial visit: optic disc hyperemia and edema and several yellowish subretinal lesions located in the posterior pole and lower midperiphery. b After 6-month therapy: decreased optic disc hyperemia and edema and increased choroidal granulomas. c After 18-month therapy: decreased choroidal granulomas
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PMC5088489_01_40942_2015_6_Fig2_HTML.jpg
Fig2
Fundoscopy disclosed mild swollen and hyperemic optic discs and some subretinal yellowish nodules of 1/3 to 1 disc diameter, partially delimited, located in the posterior pole and midperiphery in both eyes (Figs. 1a and 2a).   Six months after the treatment began the prednisone intake was 20 mg/day, when there was a decrease in papillitis and an increase in the choroidal granuloma size (Figs. 1b and 2b). By the 18th month of treatment the intake of prednisone was 10 mg/day, leading to a gradual reduction in the choroidal granulomas' size and thickness and stabilized uncorrected visual acuity of 20/20 in both eyes (Figs. 1c and 2c).
Chest X-ray. Chest X-ray showing a suspicion of hilar lymphadenopathy, especially on the left-side
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Fig3
The Chest X-ray disclosed the suspicion of hilar lymphadenopathy, especially on the left-side (Fig. 3).
PET-Scan. PET-Scan showing increased 18 F-fluorodeoxyglucose uptake in multiple paratracheal and bilateral hilar lymph nodes
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Fig4
The PET-scan showed increased 18 F-fluorodeoxyglucose uptake in the paratracheal and bilateral hilar lymph nodes, indicating high local cellular metabolism (Fig. 4).
Histopathology. Histopathology of mediastinal lymph node, stained with hematoxylin-eosin, showing non-caseating granulomatous inflammation and multinucleated giant cells
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Fig5
A mediastinal lymph node biopsy was performed afterwards, which depicted non-caseating granulomas with multinucleated giant cells and absence of acid-alcohol resistant bacilli (Fig. 5).   