A Case of Sarcoidosis with Bilateral Pleural Effusion

Abstract

A 51-year-old woman was admitted to our hospital because of dyspnea in May 2003. A chest X-ray picture showed bilateral pleural effusion. A CT also showed bilateral effusion and diffuse spread of micronodules in both lung fields. The bronchoscopic appearances showed endobronchial plaques characteristic of sarcoidosis. The bronchoalveolar lavage showed an increased percentage of lymphocytes with high CD4/CD8 ratio (2.82). The aspiration of effusion yielded serous fluid containing lymphocyte. A thoracoscopy was performed. Biopsy specimens of pleural and lung tissues demonstrated noncaseating epithelioid cell granulomas. Based on the histological finding, sarcoidosis was diagnosed. Pleural involvement in sarcoidosis is reportedly a rare manifestation of the disease.