[A long-term follow-up case of sarcoidosis with fibrosis and silicotic nodules in the lung].

An autopsy case of a 70-year-old woman with sarcoidosis followed up for 16 years is reported. She was admitted for examination of bilateral hilar lymphadenopathy on chest X-ray film and uveitis in 1971. Sarcoid granuloma was revealed by Daniels lymph node biopsy. After steroid therapy, bilateral hilar lymphadenopathy and uveitis disappeared. However, small nodular shadows appeared in bilateral lower lung fields on chest X-ray film in 1973. Gradually small nodular shadows increased and reticular shadows appeared. In 1980, chest X-ray film revealed fibrotic change in the bilateral lung fields and giant bulla in the left upper lung field. She developed acute pneumonia and died of acute progression of chronic respiratory failure in 1987. Autopsy revealed sarcoid granulomas and honeycomb lesions in bilateral lungs and also silicotic nodules near the sarcoid granuloma in the upper lobes. This case suggests that inhaled mineral particles may play an important role in the development of pulmonary fibrosis in sarcoidosis.