4.2 Article

Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

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INTERNAL MEDICINE
卷 61, 期 3, 页码 395-400

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JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.7533-21

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sarcoid-like granulomatous lung disease; sarcoidosis; silicosis

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This article reports a case of silicosis-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, in a patient with long-term exposure to silica. The patient's pulmonary manifestations improved after discontinuation of silica exposure and combination therapy.
A 67-year-old man was admitted to our hospital with cough and fatigue. He had had long-term exposure to silica due to cement processing. Chest computed tomography showed bilateral centrilobular nodules, and hilar and mediastinal lymphadenopathy with calcification, suggesting chronic silicosis. Within a few months, these nodules enlarged, and bilateral patchy consolidations appeared. A lung biopsy revealed sarcoid-like granulomas with birefringent particles under polarized light without malignancy or infection. He was diagnosed with silicosis-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, according to the clinicopathological findings. His pulmonary manifestations improved after the discontinuation of silica exposure and combination therapy of corticosteroid and azathioprine.

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