Abstract
We report five cases with pulmonary sarcoidosis who showed clubbing, fine crackles, and interstitial opacities which should be differentiated from chronic interstitial pneumonia.
All five cases were of relatively high age (mean 52.4) at the onset and presented with fine crackles during the course of the disease. Clubbing was seen in four cases. Chest X-ray films revealed reticulonodular shadows in all cases and honeycoming in four. Serum ACE activity was elevated in four cases and BAL fluid lymphocytosis was found in two, accompanied by elevated CD4/CD8 ratio. Four cases showed restrictive lung impairment. Diagnosis of sarcoidosis was established by lymph node biopsy in three, and transbronchial lung biopsy in one case. The last case was diagnosed as having the disease by the presence of Schaumann bodies in the lungs and lymph nodes. Two cases have been observed for three and seven years, while the rest died seven, fourteen, and 21 years after the onset, respectively. The incidence of this type of disease described above was 0.6% based on our own panels of 868 patients with sarcoidosis.
