眼症状で発見された８２歳高齢者サルコイドーシスの１例

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  • Sarcoidosis in an 82-year-old Woman Who Presented with Ocular Symptoms.

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An 82-year-old woman with blurred vision consulted an ophthalmologist. She was admitted to the hospital (internal medicine) for further examination because of uveitis and cataracts. A chest X-ray film and a CT scan showed interstitial infiltration in the right middle lung field, and a Ga-scintigram showed abnormal accumulation in the same area. The mediastinal lymph nodes were not swollen, and the left lung appeared to be normal. We diagnosed her illness as sarcoidosis because the CD4/CD8 of bronchoalveolar lavage fluid from the right B4 was greater than 5.0 and because examination of a specimen obtained by transbronchial lung biopsy from the right B4 showed many non caseouse epithelioid granulomas. In contrast bronchoalveolar lavage fluid from the left B4 had a CD4/CD8 of less than 2.0 and examination of a biopsy specimen from the left B4 showed normal lung tissue. The lesion in this patient was only in the right lung, and was classified as Stage 3. However, because the lung fibrosis and the reduction in pulmonary function were minimal, the disease in this case did not fit the conventional classificaition into stages.

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