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[Sarcoidosis with pulmonary cavitation and calcification]
1Hokkaido Kitami Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi
|November 1, 1995
Summary
This case study highlights sarcoidosis, a rare granulomatous lung disease. Initial tuberculosis treatment failed, but steroid therapy for sarcoidosis led to cavitation and calcification.
Area of Science:
- Pulmonology
- Pathology
Background:
- A 38-year-old man presented with bilateral reticulo-nodular lung shadows initially misdiagnosed as pulmonary tuberculosis.
- Standard antituberculous chemotherapy proved ineffective, necessitating further investigation.
Observation:
- Elevated serum angiotensin-converting enzyme and lysozyme levels were noted.
- Transbronchial lung biopsy revealed noncaseating epithelioid-cell granulomas with severe hyalinization, leading to a sarcoidosis diagnosis.
Findings:
- Chest CT demonstrated multiple nodular opacities, some calcified.
- Cavitary lesions developed during steroid therapy tapering, despite negative bacteriological and fungal studies.
- Histopathology confirmed noncaseating epithelioid-cell granulomas.
Implications:
- The findings suggest that cavitation may be a complication of steroid therapy in sarcoidosis.
- Calcification might result from post-organizing dystrophy within the granulomatous lesions.