Pulmonary Sarcoidosis with Associated Bloody Pleurisy.

Abstract

A 64-year-old man was admitted to our hospital complaining of non-productive cough and right chest pain. Chest radiographs showed bilateral hilar lymphadenopathy, diffuse granular nodules and right pleural effusion. Serumangiotensin-II-converting enzymeand lysozyme levels were elevated. Since thoracentesis indicated bloody pleurisy, video-assisted thoracoscopy was performed and revealed multiple white nodules on both the visceral and parietal pleura. Resected pleural biopsy specimens showed non-caseous granulomas. Furthermore, somenodules were observed to compress and involve small vessels and capillaries. The bloody pleurisy was assumed to have been derived from the rupture of small vessels that had been compressed and affected by the granuloma with sarcoidosis.

Hemorrhagic pleural effusion secondary to sarcoidosis: A brief review

“…[5] Apart from the present case, to the best of our knowledge, only three cases of hemorrhagic pleural effusion secondary to sarcoidosis were published in the literature. [5–7] The detailed features of all three cases and their comparison with the present case are shown in Table 1.…”

“…[5–7] A hemorrhagic pleural effusion is a pleural effusion that looks like it is blood. The RBC count is usually greater than 1,00,000/cu mm[54] (while in the present case it was 2,20,000/cu mm).…”

Hemorrhagic sarcoid pleural effusion: A rare entity

“…A decade later, Watarai et al . [8] published a case of sarcoidosis with bloody pleural effusion, bilateral hilar lymphadenopathy, and parenchymal nodules. Kumar et al .…”

A 50‐year‐old man with stage 2 sarcoidosis with pleural involvement

“…The fluid is typically a lymphocytic exudate, and almost all cases describe a CD4 predominant lymphocytic effusion with CD4/CD8 ratios ranging from 2.35 to 8.6 1. The presence of bloody pleural effusions in sarcoidosis most likely represents the rupture of small vessels that are compressed or infiltrated by granulomas 4…”