Abstract
A 19-year-old man in whom sarcoidosis of the eye had been suspected was admitted for further examination. He had already recieved steroid therapy. His chest roentgenogram revealed no abnormal findings, and his levels of serum angiotensin-converting enzyme and lisozyme was normal. Purified protein derivative (PPD) test results were negative. Fiberoptic bronchoscopy revealed mucosal hypervascularity in both main bronchi. The lymphocyte percentage and CD 4/8 ratio in bronchial alveolar lavage fluid increased. No granulomatous lesion was found by transbronchial lung biopsy, but the above results clinically suggested a diagnosis of sarcoidosis. At fiberoptic bronchoscopy, a yellowish-white single multinodular protruding lesion was detected in the right lower lobe bronchus. Since the biopsy specimen contained tumor cells with eosinophilic granular cytoplasm which stained positively with anti S-100 protein antibody, the diagnosis of granular cell tumor was confirmed. The tumor was not detected half a year later, but long-term follow up is neccessary. In our review of the literature, co-existence of endobronchial granular cell tumor with sarcoidosis is very rare, and this is only the second report in Japan.
