Sarcoidosis with Major Airway, Vascular and Nerve Compromise

Hiroshi Sekiguchi,James P Utz,Jun Suzuki

doi:10.1155/2013/273535

Abstract

The present report describes a 60-year-old Caucasian woman who presented with progressive dyspnea, cough and wheeze. A computed tomography scan of the chest showed innumerable bilateral inflammatory pulmonary nodules with bronchovascular distribution and a mediastinal and hilar infiltrative process with calcified lymphadenopathy leading to narrowing of lobar bronchi and pulmonary arteries. An echocardiogram revealed pulmonary hypertension. Bronchoscopy showed left vocal cord paralysis and significant narrowing of the bilateral bronchi with mucosal thickening and multiple nodules. Transbronchial biopsy was compatible with sarcoidosis. Despite balloon angioplasty of the left lower lobe and pulmonary artery, and medical therapy with oral corticosteroids, her symptoms did not significantly improve. To the authors' knowledge, the present report describes the first case of pulmonary sarcoidosis resulting in major airway, vascular and nerve compromise due to compressive lymphadenopathy and suspected concurrent granulomatous infiltration. Its presentation mimicked idiopathic mediastinal fibrosis.

Highlights

Le présent rapport décrit le cas d’une femme blanche de 60 ans qui a consulté en raison d’une dyspnée progressive, d’une toux et d’une respiration sifflante
CASE prESEntAtion A 60-year-old Caucasian female nonsmoker presented with a fiveyear history of progressive exertional dyspnea associated with chronic cough
Balloon angioplasty of the left lower lobe pulmonary artery was performed with mild improvement in calibre (Figure 2)

Summary

Introduction

Le présent rapport décrit le cas d’une femme blanche de 60 ans qui a consulté en raison d’une dyspnée progressive, d’une toux et d’une respiration sifflante. Un échocardiogramme a révélé une hypertension pulmonaire, tandis que la bronchoscopie a exposé une paralysie des cordes vocales gauches et un important rétrécissement des bronches bilatérales avec un épaississement muqueux et de multiples nodules. 2. To understand the pathophysiology of sarcoidosis-associated pulmonary hypertension (SAPH). What are the proposed mechanisms of sarcoidosis-induced central airway narrowing or bronchial stenosis?

Results

Conclusion