A Case of Sarcoidosis with Pulmonary Fibrosis and Lung Cancer

概要

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A 64-year old man was admitted to the hospital because of progressive dyspnea. His chest X-ray showed diffuse reticulonodular shadows in the lower lung fields and HRCT revealed ground-galss opacities and fibrotic patterns similar to idiopathic pulmonary fibrosis. He had hypoxemia and his serum ACE was elevated. The specimen obtained at open lung biopsy showed non-necrotizing epithelioid cell granuloma with multinucleated giant cells in lung parenchyma, establishing the diagnosis of sarcoidosis. By steroid therapy his clinical and radiological findings had been improved. Two years after the initial admission he died of squamous cell carcinoma in the left upper lobe. The postmortem lung showed honeycombing in the subpleural area and slightly thickened alveolar wall in the inner area, but granulomatous lesion was unable to be found. We reported a case of sarcoidosis which had unusual course and radiological findings.
日本サルコイドーシス/肉芽腫性疾患学会の論文