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- Tamura Masahito
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine
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- Hayashi Toshinari
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
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- Nagatomo Hiroko
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
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- Yoshii Chiharu
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
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- Tao Yoshiaki
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
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- Nikaido Yoshihiko
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
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- Nagata Nobuhiko
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
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- Kido Masamitsu
- Division of Respiratory Disease University of Occupational and Environmental Health, School of Medicine
Bibliographic Information
- Other Title
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- 高度の線維化，嚢胞性変化を呈した若年サルコイドーシスの１例
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Abstract
A 29-year-old man was referred to our hospital because of exertional dyspnea and progressive eruption on the buttocks and the lower extremities. Chest roentgenograms and computed tomograms taken at that time revealed diffuse fibrotic changes accompanied by multiple cavities and bullae in the lungs. There were no signs of mediastinal or hilar lymphadenopathy. A chest roentgenogram taken 7 years before admission showed no abnormalities. Serum ACE and lysozyme levels were high: 29.9IU/l and 14.1μg/ml, respectively. 67Ga scintigraphy showed diffuse uptake in both lung fields. The PPD skin test was negative, and repeated sputum smears and cultures were negative for pyogenic bacteria and acid-fast bacilli. Examination of transbronchial lung biopsy and skin biopsy specimens confirmed the diagnosis—they showed noncaseating epithelioid granulomas with giant cells and a negative reaction of the stain to acid-fast bacilli, which are compatible with sarcoidosis. The patient was given 30mg/d of prednisone orally. The dyspnea and eruption were clearly alleviated, although there was little roentgenographic regression of cystic or fibrotic changes.<br>There have been only a few reports of cystic and fibrotic changes early in the course of sarcoidosis. The cystic lesions in this case were probably secondary pulmonary cavities caused by the contracting and obstructive changes related to pulmonary fibrosis.
Journal
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- The Japanese journal of thoracic diseases
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The Japanese journal of thoracic diseases 33 (3), 358-362, 1995
The Japanese Respiratory Society