A Case of Pulmonary Sarcoidosis with Endobronchial Nodular Involvement

Abstract

Sarcoidosis is a multisystemic disorder of unknown cause that is characterized pathologically by noncaseating granulomas. Diagnosis is based on the exclusion of other infectious, interstitial, and neoplastic diseases and on the typical pathology. Although the lungs and mediastinal lymph nodes are almost involved, endobronchial nodular lesions of sarcoidosis with lung involvements are rare. We report a case of sarcoidosis with lung involvements and endobronchial nodules as confirmed by bronchial biopsy.

Dry cough in a middle-aged man

“…These nodules give rise to cobblestoning or pebbly mural appearance. [10] Biopsy from these nodules demonstrates noncaseating granulomas. In cases of normal endobronchial tree also, biopsies from secondary and tertiary carina may yield the diagnosis in 30% of cases.…”

Multinodule abnormalities of the tracheobronchus: bronchoscopy findings and clinical diagnosis

“…In addition, most of the biopsy was performed by different pulmonologists, so there was a lack of standardization across diagnoses. Therefore, in cases where the pathological diagnosis turned out to be chronic inflammation, a diagnosis of TO, TB or even other diseases, like sarcoidosis may have been more appropriate . Although doctors in the respiratory department were required to achieve at least six tissue samples for each patient, the depth and position of each biopsy is important for accurate pathological diagnosis.…”

“…Multiple nodules, however, are associated with various conditions. For example, amyloidosis , tracheobronchopathia osteochondroplastica (TO) , relapsing polychondritis, trachea‐bronchomegaly, endobronchial metastases (EBM) , sarcoidosis , neurofibromatosis, rheumatoid arthritis , tuberculosis (TB) and other granulomatous lesions, such as granulomatosis with polyangitis and lymphomas .…”

A case of pulmonary sarcoidosis with endobronchial nodules

“…Cho et al . reported a case of sarcoidosis with endobronchial nodules and peribronchial infiltration. Systemic corticosteroids are the mainstay of treatment of sarcoidosis.…”