A Case of Necrotizing Sarcoid Granulomatosis

Kim, Gye Su; Lee, Seung Joon; Lee, Jae Chul; Yoo, Chul Gyu; Kim, Young Whan; Han, Sung Koo; Shim, Young Soo

Abstract

Necrotizing sarcoid granulomatosis was first described by Liebow, who included it in the category of pulmonary angiitis and granulomatosis. Wegener's granulomatosis and limited Wegener's granulomatosis are also included in this category. Necrotizing sarcoid granulomatosis is characterized by histologically sarcoid-like granulomata, prominent and granulomatous vasculitis, and varying degrees of necrosis, radiographically pulmonary nodules but no enlarged hilar lymph nodes, clinically benign course. Whether this entity is a variant of necrotizig vasculitis with sarcoid reaction or sarcoidosis with prominent vascultic features and necrosis is not yet, clear, but many authors suggest the relationship with sarcoidosis from the observation of the similarity of histologic features and clinical course between the two entities. Patients are asymptomatic in about one fourth. Even symptomatic patients have vague symptoms such as cough, chest pain. Extrapulmonary involvement is rare. The prognosis is good even without therapy or with steroid alone, if necessary. We report a case that was diagnosed by open lung biopsy as necrotizing sarcoid granulomatosis, and it is assumed to be the first report of this entity in Korea.