Primary acute pulmonary cavitation in asymptomatic sarcoidosis

Sarcoidosis has a large variety of chest x-ray manifestations, but primary acute cavitation is very rare. We report a case of cavitary sarcoidosis occurring in an asymptomatic 25 year-old white patient. The diagnosis was established from chest x-ray, transbronchial biopsy specimen, bronchoalveolar lavage and gallium 67 scan. The peculiarities of this case are: 1) the presence of hilar adenopathy; 2) the cavitation occurred during the decreased activity of the disease; 3) the resolution of cavity without therapy. We suggest asymptomatic sarcoidosis should be considered in the differential diagnosis of pulmonary cavitation.