[Case of primary cavitary sarcoidosis: exacerbation after 16 years from onset].
A 46-year-old man presented with the complaint of cough, fever and dyspnea on exercise. Sixteen years previously stage II sarcoidosis was diagnosed, with an ocular lesion. So far, he had had no respiratory symptoms and was followed up without medication. Two months before his visit, he had a cough. He gradually developed a fever and felt dyspnea on exercise. Chest X-ray showed an infiltrative shadow with a cavity in the right upper lobe. Bronchofiberscopy was performed and the biopsy specimen from the cavity wall revealed noncaseating epitheloid cell granulomas, suggesting primary cavitary sarcoidosis. Corticosterid therapy was started. His symptoms improved rapidly, and the infiltrative shadow on the right upper lobe decreased within one month. The cavity wall was thin on the following computed tomography. Thirty-two cases of primary cavity sarcoidosis were reported in Japan from 1975-2005. The mean age of the patients was 26.5 years old and the ratio of males to females was 13:3. In most cases, corticosteroid therapy was effective and nine spontaneously improved cases were reported. To determine the indications for steroid therapy, further examination is needed.
Shikama
Yusuke
Y
Respiratory Disease Center, Showa University Northern Yokohama Hospital.
Takase
Hiroyasu
H
Takamiya
Yusuke
Y
Hamazaki
Nanae
N
Shibuya
Yasuhiro
Y
Satou
Yoko
Y
Kuriu
Kazuyuki
K
Kamio
Yoshito
Y
Kitami
Akihiko
A
Kasahara
Keita
K
Nakajima
Hiroaki
H
D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D013902:Radiography, Thoracic; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005938:Glucocorticoids; D011239:Prednisolone