A Case of Sarcoidosis That Had Problems for Differential Diagnosis from Hypersensitivity Pneumonitis

Abstract

A 76-year old man, who had been diagnosed as sarcoidosis for eye symptoms, was admitted to a local hospital with dyspnea and hypoxemia. His chest X-ray and CT revealed diffuse ground glass opacity. He was transferred to our hospital for further examination. His symptoms and chest X-ray findings improved rapidly without any treatment. Histological examination of transbronchial lung biopsy and his clinical features suggested hypersensitivity pneumonitis rather than sarcoidosis. After 6 months, he had a fever with nodular shadows in the right lower lung field on the chest X-ray. Thoracoscopic lung biopsy was done, and a diagnosis of lung sarcoidosis was confirmed. This was an extremely rare case of sarcoidosis, which was clinically difficult to distinguish from hypersensitivity pneumonitis.