A Case Report of Pulmonary Sarcoidosis: An Uncommon Cause of Chest Pain

Clinical Practice and Cases in Emergency Medicine
Justina Truong, John Ashurst

Abstract

Chest pain is one of the most common causes of emergency department visits on an annual basis and carries a high degree of morbidity and mortality if managed inappropriately. A 36-year-old male presented with four months of left-sided chest pain with dyspnea on exertion. Physical examination and laboratory values were within normal limits. Chest radiograph depicted diffuse interstitial nodular opacities throughout the lungs bilaterally with bilateral perihilar consolidations. Computed tomography of the chest demonstrated mid and upper lung nodularity with a perilymphatic distribution involving the central peribronchial vascular regions as well as subpleural and fissural surfaces causing conglomerate in the upper lobes centrally with associated hilar and mediastinal lymphadenopathy. The next day the patient underwent bronchoscopy with endotracheal ultrasound and transbronchial biopsies and pathology revealed non-necrotizing, well-formed granulomas embedded in dense hyaline sclerosis consistent with sarcoidosis. Sarcoidosis is a multi-system granulomatous disease characterized by noncaseating granulomas on pathology. The worldwide epidemiology of sarcoidosis is currently unknown due to many patients being asymptomatic. However, p...Continue Reading

References

Jul 17, 2014·Current Opinion in Pulmonary Medicine·Alicia K Gerke
Nov 26, 2015·Clinics in Chest Medicine·Dominique ValeyreHilario Nunes
Jul 22, 2017·Chest·Gamze KirkilRobert P Baughman
Dec 12, 2017·Chest·Karen C Patterson, Edward S Chen
Jan 5, 2018·Internal and Emergency Medicine·Elena Bargagli, Antje Prasse

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