title: Retrograde radiographic development in pulmonary sarcoidosis.
abstract: A 48-year-old man with dyspnea, cough, and fever was found to have a diffuse ground-glass pulmonary lesion without lymphadenopathy on chest X-ray. The lesion shifted to the peripheral lung zones 2 months later when transbronchial biopsy demonstrated noncaseating granulomas with Langhans type giant cells. After 6 more months, prominent bilateral hilar lymphadenopathy and highly elevated serum angiotensin-converting enzyme confirmed the diagnosis of pulmonary sarcoidosis. Such a course is quite rare in that it goes the opposite way of the conventional staging system.
authors.affiliation: Department of Respiratory Medicine, Hokkaido Social Insurance Hospital, Sapporo.
authors.forename: Akihide
authors.initials: A
authors.lastname: Ito
authors.forename: Michihiro
authors.initials: M
authors.lastname: Fujino
authors.forename: Akira
authors.initials: A
authors.lastname: Isada
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Ito
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Atsuo
authors.initials: A
authors.lastname: Hattori
authors.forename: Fujiya
authors.initials: F
authors.lastname: Kishi
mesh_terms: D003937:Diagnosis, Differential; D018450:Disease Progression; D015769:Granuloma, Respiratory Tract / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed