title: [A case of pulmonary sarcoidosis with usual interstitial pneumonia-like lesions distributed predominantly in the lower lung fields].
abstract: In 2000, in a 75-year-old man, nodular and reticular opacities were detected in both lower lung fields. He was admitted to our hospital for further examination of these abnormal shadows. Bronchoscopic examination revealed pulmonary sarcoidosis. Prednisolone was prescribed because cardiac sarcoidosis was diagnosed as a clinical complication. In April 2002, the patient visited our hospital for dyspnea on effort. Chest radiography and computed tomography showed nodular and reticular opacities in the right upper lobe, and video-assisted thoracoscopic surgery was performed on the basis of a histological diagnosis. The histological findings of the biopsied specimens revealed a lesion of the type seen in usual interstitial pneumonia, whereas non-caseous granulomas were not detected. His symptoms and chest radiographic findings improved and stabilized with prednisolone and azathioprine. In the present case of pulmonary sarcoidosis, the reticular and nodular opacities predominantly distributed in both lower lung fields, and the histological findings obtained by video-assisted thoracoscopic surgery showed a usual interstitial pneumonia-like lesion. These findings may assist in the understanding of the process of development of pulmonary sarcoidosis.
authors.affiliation: Department of Internal Medicine, Kurobe City Hospital, 1108-1 Mikkaichi, Kurobe, Toyama 938-8502, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Nobata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuji
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kasai
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Ishiura
authors.forename: Masahide
authors.initials: M
authors.lastname: Yasui
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kasahara
authors.forename: Masaki
authors.initials: M
authors.lastname: Fujimura
authors.forename: Eisuke
authors.initials: E
authors.lastname: Takazakura
mesh_terms: D000368:Aged; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging