A Case of Sarcoidosis Without Bilateral Hilar and Mediastinal Lymphadenopathy That Was Diagnosed from Multiple Intrapulmonary Lymph Nodes

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  • Tamagaki Gakuya
    Department of Respiratory Medicine, Izumi City Hospital Department of Respiratory Medicine, Osaka JR General Hospital
  • Matsushita Haruhiko
    Department of Respiratory Medicine, Izumi City Hospital

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  • 縦隔肺門リンパ節腫大を呈さず多発肺内リンパ節から診断に至った肺サルコイドーシスの1例

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Abstract

<p>Case. A 56-year-old woman consulted an ophthalmologist due to right eye pain in September 2012. She was diagnosed with right-sided iritis and glaucoma. Based on the ophthalmologic findings and negativity for Mantoux reaction, she was referred to our hospital with suspected sarcoidosis. Chest computed tomography showed seventeen small irregular nodular shadows of 5-8 mm in size in the lungs without bilateral hilar or mediastinal lymphadenopathy. A definitive diagnosis could not be obtained by bronchoscopy with transbronchial biopsy. Thus, in February 2013, she underwent a surgical lung biopsy from left segment 8, which included two black nodules in order to obtain a definitive diagnosis. Histologically, the two black nodules were intrapulmonary lymph nodes containing non-caseating epithelioid cell granulomas. In addition, the lung tissue showed non-caseating epithelioid and giant cell granulomas in the pulmonary interstitium. We made a diagnosis of sarcoidosis. Conclusion. We reported a rare case of sarcoidosis involving the intrapulmonary lymph nodes without bilateral hilar or mediastinal lymphadenopathy.</p>

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