[A case of sarcoidosis complicated with repeated hemoptysis]

A 53-year-old woman was admitted to our hospital complaining of repeated hemoptysis. Her past history indicate uveitis at age 48. Chest HRCT findings showed the thickening of broncho-vascular bundles, interlobular septal thickening, and patchy ground-glass attenuation, but no hilar and mediastinal lymphadenopathy. BALF and TBLB were not diagnostic. Her hemoptysis was persistent, and we performed VATS biopsy, which revealed diffuse epithelioid cell granulomas with multinucleated giant cells along vessels and intra-alveolar spaces, consistent with sarcoidosis. Sarcoidosis was therefore diagnosed. She was treated with steroids, and her CT findings improved, but her hemoptysis was persistent. Bronchial artery angiography revealed micro-aneurysms in the left bronchial artery and shunt to the pulmonary vein form the right bronchial artery. We decided that the etiology of her hemoptysis was from micro-aneurysms in the left bronchial artery. We concluded that hemorrhage from vascular lesions, including the bronchial artery, could be complications in cases of sarcoidosis.