Aggravating cough in a patient with suspected sarcoidosis
- Department of Pneumology, Katholieke Universiteit Leuven and Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
- Correspondence to Dr Jonas Yserbyt, Department of Pneumology, University Hospital Gasthuisberg Herestraat 49, Leuven 3000, Belgium; jonas.yserbyt{at}uzleuven.be
- Received 10 April 2012
- Accepted 4 May 2012
- Published Online First 4 July 2012
A middle-aged patient with a recent history of a complete surgical resection of a nodular melanoma of the lower back, was referred to the clinic because of increasing exertional dyspnoea. A chest CT showed multiple enlarged mediastinal adenopathies with a micronodular interstitial pattern (figure 1). Transbronchial biopsies revealed non caseating granulomas. Moreover, because ofatrioventricular junctional arrhythmia, an MRI scan of the heart was performed, which showed myocardial granulomas. Sarcoidosis was diagnosed and treated with steroids.
Chest CT scan showing an enlargement of multiple mediastinal adenopathies, with a multinodular interstitial pattern of perilymphatic distribution on top, predominantly on the right side.
Because of the aggravating cough, a second flexible bronchoscopy was performed four months later this and showed a dark …
