PNEUMOTHORAX AS A FIRST MANIFESTATION OF SARCOIDOSIS

Pneumothorax is a rare manifestation of sarcoidosis, occurring usually late in the course of the disease. We report five cases of pneumothor ax as a presenting manifestation of sarcoidosis. In two patients, thor acotomy showed extensive pleural infiltration by noncaseating granulom as. High-resolution CT scans showed cavitated subpleural nodules and s ubpleural bullae in one case. These findings support that necrosis of subpleural granulomas Iupture of a subpleural bullae or both, are the mechanisms of pneumothorax in sarcoidosis. Three patients with a lung function impairment were treated with oral corticosteroids. One nontre ated patient died due to progression of the disease.