[Pulmonary necrotizing sarcoid granulomatosis in a patient with primary biliary cirrhosis].
METHODS
A 53-year-old woman presented with recurrent episodes of cough and non-specific pulmonary symptoms. For many years she had been known to have primary biliary cirrhosis.


METHODS
The chest X-ray showed multiple pulmonary nodules. Microbiological examination did not detect any pathogen and transbronchial biopsy of the pulmonary nodules failed to provide a diagnosis. Histology of a surgical lung biopsy showed interstitial inflammation, vasculitis and non-caseating granulomas.


METHODS
The findings indicated necrotizing sarcoid granulomatosis. During oral corticoid therapy the pulmonary nodules regressed within a few weeks. The patient has remained free of pulmonary symptoms.


CONCLUSIONS
Pulmonary necrotizing sarcoid granulomatosis is a rare condition to consider in the differential diagnosis of pulmonary nodules. Because of the histological findings and its benign course it resembles sarcoidosis.
Frechen
D
D
Medizinische Klinik I, Universitätsklinikum der RWTH Aachen, Aachen. dfrechen@ukaachen.de
Cornelissen
C
C
Schreiner
K
K
Jäkel
J
J
Krüger
S
S
D001706:Biopsy; D003371:Cough; D003937:Diagnosis, Differential; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D015769:Granuloma, Respiratory Tract / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008168:Lung / Q000473:pathology*; D008875:Middle Aged; D009336:Necrosis / Q000150:complications / Q000175:diagnosis; D011239:Prednisolone / Q000627:therapeutic use; D017565:Sarcoidosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids; D011239:Prednisolone