title: Pneumothorax as a first manifestation of sarcoidosis.
abstract: Pneumothorax is a rare manifestation of sarcoidosis, occurring usually late in the course of the disease. We report five cases of pneumothorax as a presenting manifestation of sarcoidosis. In two patients, thoracotomy showed extensive pleural infiltration by noncaseating granulomas. High-resolution CT scans showed cavitated subpleural nodules and subpleural bullae in one case. These findings support that necrosis of subpleural granulomas or rupture of a subpleural bullae, or both, are the mechanisms of pneumothorax in sarcoidosis. Three patients with a lung function impairment were treated with oral corticosteroids. One nontreated patient died due to progression of the disease.
authors.affiliation: Department of Thoracic Medicine, Medical School, University of Crete, Greece. frudarak@edu.uch.gr
authors.forename: M E
authors.initials: ME
authors.lastname: Froudarakis
authors.forename: D
authors.initials: D
authors.lastname: Bouros
authors.forename: A
authors.initials: A
authors.lastname: Voloudaki
authors.forename: S
authors.initials: S
authors.lastname: Papiris
authors.forename: Y
authors.initials: Y
authors.lastname: Kottakis
authors.forename: S H
authors.initials: SH
authors.lastname: Constantopoulos
authors.forename: N M
authors.initials: NM
authors.lastname: Siafakas
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed