[Primary lung cancer (adenocarcinoma) associated with cardiac sarcoidosis]

A 56-year-old woman who had been given oral prednisolone for iridocyclitis by an ophthalmologist received a diagnosis of pulmonary sarcoidosis on the basis of transbronchial lung biopsy findings, and began receiving therapy at our hospital on an outpatient basis. Chest X-ray films disclosed hilar lymphadenopathy in both lungs. In addition, Holter electrocardiograms detected ventricular premature beat (Lown 4B) and echocardiograms detected reduced left ventricular wall motion with dilatation of the left ventricular chamber. Cardiac sarcoidosis developed in the patient. She was admitted to our hospital because of shortness of breath on exertion. Chest X-ray films on admission disclosed a large nodular heterogeneous mass in the right upper lobe. Histologically, transbronchial lung biopsy specimens of the mass disclosed an adenocarcinoma. Although lung cancer and sarcoidosis are common, their coexistence in the same patient is not. Furthermore, the coexistence of lung cancer with cardiac sarcoidosis, as in this case, is very rare.