A case of sarcoidosis with hypoxia showing slight ground glass opacities on chest CT

A 62-year-old man had had renal dysfunction and hepatosplenomegaly since 2000. In 2006, he complained of general fatigue and hemodialysis therapy was initiated because his renal function had deteriorated worse. In May 2007, he was admitted to our hospital because his general fatigue took a turn for the worse. He also had hypoxia. A chest radiograph showed no abnormal shadows. A chest computed tomography showed ground glass opacities in both lower lobes slightly. However, 67Ga-citrate scintigraph showed marked accumulation of 67Ga-citrate in the lungs, liver, spleen and kidneys. Transbronchial lung biopsy (TBLB) and bone marrow biopsy showed noncaseating epithelioid cell granulomas, and anti-PAB antibody positive cells were detected in epithelioid cell granulomas in the TBLB specimens. Therefore we diagnosed sarcoidosis. Although we could not perform renal or liver biopsy, we assumed that he had renal and liver sarcoidosis. After oral corticosteroid therapy, his symptoms and image findings improved. We report a rare case of sarcoidosis with hypoxia showing slight ground glass opacities