Abstract
A 67-year old man presented with fever and cervical lymph nodes enlargement was found to have abnormal chest X-ray findings on May 1998. He was transferred to our hospital for further examination, and his chest X-ray and CT films revealed multiple patchy consolidation of both lungs with bilateral mediastinal and hilar lymphadenopathy. Serum level of soluble IL-2 receptor was elevated. Histopathological examination of CT-assisted lung biopsy specimens showed non-caseating epithelioid cell granulomas. On these bases, a diagnosis of sarcoidosis was considered to be most probable, although chest X-ray findings appeared to be atypical for the disease. On December 1998, he had fever again, and the deterioration of mediastinal and hilar lymph adenopathy, multiple patchy consolidation of both lungs, and the elevation of serum level of soluble IL-2 receptor were also noted. To rule out lymphoproliferative disorders, open lung biopsy was performed. Histological examination showed that non-caseating epithelioid cell granulomas in lung parenchyma and no malignancy in hilar lymph nodes. Thereafter, chest X-ray findings have been improved with a decrease in IL-2 receptor level. Clinical value of serum soluble IL-2 receptor level was discussed.
