title: [Case of primary cavitary sarcoidosis: exacerbation after 16 years from onset].
abstract: 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.
authors.affiliation: Respiratory Disease Center, Showa University Northern Yokohama Hospital.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shikama
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Takase
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takamiya
authors.forename: Nanae
authors.initials: N
authors.lastname: Hamazaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shibuya
authors.forename: Yoko
authors.initials: Y
authors.lastname: Satou
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kuriu
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kamio
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kitami
authors.forename: Keita
authors.initials: K
authors.lastname: Kasahara
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakajima
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone