Two cases of pulmonary sarcoidosis presenting with subpleural reticular shadows in the lower lobes

We herein report two unusual cases of sarcoidosis presenting with similar subpleural reticular shadows predominantly in the lower lobes with quite different pathological findings. In one patient, the lower lobe specimen contained typical epithelioid cell granulomas with subpleural and paraseptal fibrosis. However, the other patient exhibited usual interstitial pneumonia (UIP) in the lower lobe and sarcoidosis lesions in the upper lobe. Therefore, the latter patient was diagnosed with sarcoidosis complicated with UIP. Our results indicate that performing a surgical lung biopsy is necessary in order to provide appropriate management when lower lobe subpleural reticular shadows are present, even in patients with suspected sarcoidosis.