Pneumothorax in sarcoidosis.

We have observed four patients with sarcoidosis who developed pneumothorax. In one of the patients who had a thoracotomy, non-caseating granulomata were seen to be extensively involving the pleura. The patient had five episodes of spontaneous pneumothorax involving both lungs before and after surgery. Such episodes were not observed following insititution of corticosteroid therapy. Whether pneumothorax and sarcoidosis are two independent processes occurring in the same individual or whether the pneumothorax is causally related to the sarcoidosis has not been determined. The fact that the sarcoidosis is usually very extensive before pneumothroax develops would suggest the latter. Rupture of emphysematous blebs or necrosis of subpleural sarcoid tubercles have been proposed as the mechanisms of pneumothorax in sarcoidosis.