Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

Yasutaka Mochizuka; Masato Kono; Mineo Katsumata; Ryutaro Hirama; Masayuki Watanuki; Yuiko Oshima; Kenichiro Takeda; Akari Tsutsumi; Hideki Miwa; Yoshihiro Miki; Dai Hashimoto; Noriyuki Enomoto; Yutaro Nakamura; Takafumi Suda; Hidenori Nakamura

doi:10.2169/internalmedicine.7533-21

CASE REPORTS

Sarcoid-like Granulomatous Lung Disease with Subacute Progression in Silicosis

Yasutaka Mochizuka, Masato Kono, Mineo Katsumata, Ryutaro Hirama, Masayuki Watanuki, Yuiko Oshima, Kenichiro Takeda, Akari Tsutsumi, Hideki Miwa, Yoshihiro Miki, Dai Hashimoto, Noriyuki Enomoto, Yutaro Nakamura, Takafumi Suda, Hidenori Nakamura

Author information

Yasutaka Mochizuka
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Masato Kono
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Mineo Katsumata
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
Ryutaro Hirama
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Masayuki Watanuki
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Yuiko Oshima
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Kenichiro Takeda
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Akari Tsutsumi
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Hideki Miwa
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Yoshihiro Miki
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Dai Hashimoto
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
Noriyuki Enomoto
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
Yutaro Nakamura
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
Takafumi Suda
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
Hidenori Nakamura
Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan

Keywords: sarcoid-like granulomatous lung disease, sarcoidosis, silicosis

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 3 Pages 395-400

DOI https://doi.org/10.2169/internalmedicine.7533-21

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Details

Abstract

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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