[A case of sarcoidosis with marked bronchial involvement]

Bronchial mucosal biopsy is considered to be a useful procedure for the diagnosis of sarcoidosis in Europe and the USA. However, bronchial involvement of sarcoidosis has seldom been reported in Japan. We report an interesting case of sarcoidosis with marked bronchial changes. A 40-year-old symptom free women visited our hospital to seek a diagnosis concerning a diffuse reticulonodular shadow in her chest X-ray film. Bronchofiberscopy showed multiple nodules, yellow white plaques and hypervascularity of the thickened edematous mucosa with severe stenosis and deformity of the lober or segmental bronchi. Bronchial mucosal biopsy as well as TBLB revealed typical non-caseating epithelioid granulomas. A pulmonary function test showed restrictive ventilatory disturbance with impaired diffusing capacity and small airway dysfunction. After corticosteroid therapy, bronchial mucosal changes disappeared and chest radiological and pulmonary function abnormalities were improved. After reviewing the bronchofiberscopic findings of 11 cases of sarcoidosis, we found bronchial mucosal changes in 8 cases. Bronchial mucosal biopsy should be regarded as an important procedure for the diagnosis of sarcoidosis.