Arakaki N, Shinzato T, Tohyama M, Miyazato A, Higa F, Ohshiro H, Kaneshima H, Saito A
First Department of Internal Medicine, University of the Ryukyus.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Oct;35(10):1136-40.
A 61-year-old woman was suspected of relapse of pulmonary tuberculosis. A chest X-ray film taken at a regular health check-up suggested relapse of pulmonary tuberculosis in a 61-year-old woman. Chest X-ray revealed irregular shadow with calcification in the upper lobe of the left lung and pulmonary tuberculosis was initially diagnosed a despite a negative reaction for acid-fast bacilli on examination of her sputum and bronchial lavage. Chest CT revealed thickened bronchi and blood vessels and nodules in the lung field. Transbronchial by biopsy failed to reveal caseating epithelioid cell granulomas transbronchial lung biopsy. Past history of facial palsy, uveitis, high plasma levels of angiotensin-converting enzyme (31.6IU/L), and abnormal HRCT levels. Bronchoalveolar lavage analysis revealed an increase in lymphocytes and a CD4/CD8 ratio of 8.67. Sarcoidosis was diagnosed after a liver biopsy. This appears that HRCT findings are useful in the diagnosis of pulmonary sarcoidosis.
