Tuberc Respir Dis.  2008 Mar;64(3):236-239. 10.4046/trd.2008.64.3.236.

A Pulmonary Sarcoidosis Manifesting as a Rare Atypical Pattern and Distribution

• Hong SH
• Kang EY
• Woo OH
• Yong HS
• Oh YW
• Shin BK
• Shim JJ

• KMID: 1478188
• DOI: http://doi.org/10.4046/trd.2008.64.3.236

Abstract

A unique case of atypical pulmonary sarcoidosis in a 62-year-old man complaining of dyspnea is presented. Chest CT scan showed an unusual pattern and distribution of pulmonary sarcoidosis manifesting mainly as reticular densities, interlobular septal thickening, and ground-glass opacities, in the subpleural and lower lung predominancy. However, a surgical lung biopsy revealed classical findings of sarcoidosis. Knowledge of this atypical pulmonary involvement may improve understanding sarcoidosis as the great masquerader.

Keyword

Sarcoidosis; Pulmonary disease; CT

MeSH Terms

Biopsy
Dyspnea
Humans
Lung
Lung Diseases
Middle Aged
Sarcoidosis
Sarcoidosis, Pulmonary
Thorax

Figure

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  Figure 1 Chest PA view shows bilateral hilar lymphadenopathies.

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  Figure 2 Thin-section CT with lung window setting (A, B) shows fine reticular densities, faint ground-glass opacities, and interlobular septal thickenings on both lungs, predominantly the lower subpleural lung zone. Enhanced chest CT scan with a mediastinal window setting (C) shows bilateral mediastinal and hilar lymphadenopathies.

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  Figure 3 Surgical lung biopsy specimen shows extensive infiltration by noncaseating granulomas distributed along the pleura, interlobular septa, and bronchovascular bundles (H&E stain, ×40).

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