Sarcoidosis: recurrence of primary disease in transplanted lungs.

PURPOSE

To assess findings of recurrent disease on thin-section computed tomographic (CT) studies and results of bronchoalveolar lavage and transbronchial biopsy (BAL-TBB) procedures performed in adult lung transplant recipients.

MATERIALS AND METHODS

Between 1990 and 1993, 32 single-lung, 14 double-lung, and three heart-lung transplantation procedures were performed in 47 patients; 176 thin-section CT scans were reviewed, with a mean follow-up of 18.9 months after transplantation.

RESULTS

Sarcoidosis was diagnosed after BAL-TBB of the lung allografts 3 and 15 months after transplantation in both patients without symptoms who received transplants for treatment of sarcoidosis. In one patient, diffuse miliary nodules seen on chest radiographs and thin-section CT scans disappeared after administration of an increased dose of corticosteroids; in the other patient, no radiologic finding of sarcoidosis was present. No recurrence was seen in patients who received transplants for treatment of other diseases.

CONCLUSION

Recurrence of primary disease should be considered whenever abnormalities are seen on chest radiographs or thin-section CT scans. Sarcoidosis may recur with or without radiologic findings after transplantation.