[Pleurisy and sarcoidosis]

Two cases of sarcoidosis associated with pleurisy are presented. The pleural effusion had the same characteristics in both cases. Histology showed non-caseating epithelioid and giant cell granulomas in the parietal pleura. The first case was consistent with sarcoid pleurisy, but in the second case culture of a pleural biopsy specimen fragment demonstrated tuberculous pleurisy. Pleurisy may complicate sarcoidosis in about 2.5% of patients, notably in extensive pulmonary sarcoidosis with extrathoracic lesions. The clinical presentation and the appearance of the pleural fluid are varied. In most cases, a predominantly lymphocytic sero-fibrinous exudate is present. Thorough bacteriological studies, best performed on pleural tissue cultures, must follow the discovery of non-caseating tuberculoid granulomas which are also found in tuberculous pleurisy. Among the various pathogenetic theories considered, the immune reaction theory deserves special mention.