A Case of Endobronchial Sarcoidosis with Recurrent Pneumonia

Sarcoidosis is a chronic, multisystem and non-caseating granulomatous disease of unknown etiology. Its diagnosis is based on a combination of clinical and radiographic findings and the demonstration of typical granulomas, and can often be made based on the exclusion of other granulomatous diseases. There is lung involvement in 90% of cases, often in the form of parenchymal disease, while involvement in the form of an endobronchial mass is a rarer condition. Our patient underwent bronchoscopy after being diagnosed with sarcoidosis around 3 years earlier, and was followed up without treatment due to a history of pneumonia that had recurred three times in the same localization in the previous year. An endobronchial lesion was identified on bronchoscopy, while a biopsy revealed granulomatous inflammation. Progressive sarcoidosis was considered based on the clinical and radiological findings and the patient was started on steroid treatment. We present this study of a case of sarcoidosis with recurrent pneumonia in the same localization and endobronchial involvement to emphasize the need to consider sarcoidosis in the differential diagnosis of endobronchial mass lesions.

Tekrarlayan Pnömoni ile Seyreden Endobronþiyal Sarkoidoz Olgusu

Sarkoidoz etiyolojisi bilinmeyen, kronik, multisistemik nonkazeifiye granülomatöz bir hastalýktýr. Tanýsý, klinik ve radyografik bulgularýn birlikteliðine, tipik granülomlarýn gösterilmesine dayanýr ve çoðu zaman diðer granülomatöz hastalýklarýn dýþlanmasýyla konulabilir. Akciðer tutulumu %90 oranýndadýr. Sarkoidozda akciðer tutulumu sýklýkla parankimal hastalýk þeklindeyken, nadiren endobronþiyal kitle þeklinde tutulum görülebilir. Yaklaþýk 3 yýl önce sarkoidoz tanýsý konan ve tedavisiz izlemde olan olgumuza son bir yýl içinde ayný lokalizasyonda üç kez tekrarlayan pnömoni öyküsü olmasý nedeniyle bronkoskopi yapýldý. Bronkoskopide endobronþiyal lezyon görülüp alýnan biyopsisinde granülomatöz inflamasyon saptanan hastada klinik, radyolojik bulgularla progresif sarkoidoz düþünüldü ve steroid tedavisi baþlandý. Ayný lokalizasyonda tekrarlayan pnömoni ile gelen ve endobronþiyal tutulum gözlenen sarkoidoz olgusunu, endobronþiyal kitle lezyonlarýn ayýrýcý tanýsýnda sarkoidozu vurgulamak için sunduk.