Pneumothorax and nodular lung masses are unusual manifestations in thoracic
sarcoidosis. We report two cases of pneumothoraces as presenting manifesta
tions of sarcoidosis. For the first patient thoracoscopy showed extensive p
leural infiltration by noncaseating granulomas as well as subpleural bullae
and blebs supporting that necrosis of subpleural granulomas or rupture of
blebs/bullae, or both, are the mechanisms of pneumothorax for such patient.
The other patient suffered from inaugural pneumothorax with nodular pulmon
ary sarcoidosis as bilateral lung masses mimicking metastatic lung cancel:
Test of pulmonary function showed no restriction but moderate obstructive d
efect. With no treatment the chest radiograph improved and became normal 9
months after the diagnosis suggesting that steroid therapy is not mandatory
for such patients.