Sarcoidosis as a rare cause for symmetrical giant bullous diseaseReport as inadecuate

Sarcoidosis as a rare cause for symmetrical giant bullous disease - Download this document for free, or read online. Document in PDF available to download.

BMC Pulmonary Medicine

, 17:88

Infectious, Rare and Idiopathic Pulmonary Diseases


BackgroundSarcoidosis presents with typical clinic-radiological findings and shows histologically non-caseating granulomas. Pulmonary manifestations of sarcoidosis can be diverse, involving the intrathoracic lymph nodes and pulmonary parenchyma.

Case presentationWe here describe a case of a 35-year-old patient who presented with a history of exertion dyspnoea and coughing for the past 20 years. At the age of 15, she was exposed to smoke emanating from a fire. Later, she had exposure to mold for two years, and during her childhood, she had animals such as a cockatiel, dog, cat, gecko, and turtle. Computed tomography of the chest revealed symmetrical apical giant bullous lesions. Histology of the resected bullae showed prominent peribronchial fibrosis with non-necrotizing, non-caseating granulomas and collaps of pulmonary lobules adjacent to the bulla. The absence of granulomatous infection and a markedly elevated CD4:CD8 ratio in bronchoalveolar lavage analysis suggested that the underlying process was sarcoidosis.

ConclusionIn very rare cases, sarcoidosis can be associated with bilateral symmetrical apical giant bullous disease due to fibrotic and granulomatous changes resulting in a restriction of lung tissue.

KeywordsSarcoidosis Lung Giant bullous disease Hypersensitivity pneumonitis AbbreviationsCTComputed tomography

DLCODiffusing capacity or Transfer factor of the lung for carbon monoxide

FEV1Forced expiratory volume in 1 s

FVCForced expiratory vital capacity

HSPHypersensitivity pneumonitis

PCRPolymerase chain reaction

Author: Wolfgang Jungraithmayr - Elisa Leggeri - Walter Weder - Bart Vrugt


Related documents