AN AUTOPSY CASE OF ANCIENT SARCOIDOSIS ASSOCIATED WITH SEVERE FIBROSIS IN THE LIVER AND HEART

An autopsy case of ancient sarcoidosis with severe fibrosis in the liv er and heart was reported. The patient was a 61-year-old female when s he died, 12 years after the onset of sarcoidosis, Cervical lymph node biopsy at 49 years demonstrated non-necrotizing sarcoid granuloma, and laboratory data were compatible with sarcoidosis. Liver and heart fai lure were observed clinically, and because of heart failure a pacemake r was implanted, She died of septic shock at 61 years, At autopsy, the liver demonstrated cirrhotic severe fibrosis, cholestasis, and acute cholangitis without mechanical bile duct obstruction, In the heart, se vere fibrosis was observed, and infectious foci of candida infection w ere observed on the cardiac valves, Although both liver and heart did not show typical sarcoid granuloma, fibrosis was thought to be due to sarcoidosis because no other causes of liver and heart fibrosis were i dentified clinically or pathologically. There were systemic foci of ca ndida infection, and she died of sepsis due to candida infection. It w as speculated that immunological impairment induced candida infection. This case seems to be a rare and important case of ancient sarcoidosi s.