ObjectiveTo assess the prognosis of asymptomatic pulmonary sarcoidosis with normal lung function. MethodsEighty-two patients with asymptomatic pulmonary sarcoidosis,diagnosed in Guangzhou Institute of Respiratory Diseases between July 2007 and November 2013,were followed for 24 months.The clinical data were collected and analyzed. Results31.7% of the patients showed spontaneous remission without therapy,whereas 39.0% deteriorated and 29.3% remain stable.There was no significant difference between the remission group and the progressive sarcoidosis group with regard to FEV1.17.1% of patients in the progressive sarcoidosis group had a decline in FEV1,while 73.8% had a reduced FVC,and 28.3% had a reduced DLCO.At the beginning of observation,TNF-α level was higher in the progressive sarcoidosis group compared with the remission group and the stable group[(173.5±37.8) μg/mL vs.(102.6±82.7) μg/mL and(131.7±57.9) μg/mL,P<0.05].In the progressive sarcoidosis group,TNF-α at the end time of the observation was higher than that at the beginning[(229.2±76.7) μg/mL vs.(173.5±37.8) μg/mL,P<0.05].The neutrophil in BALF was significantly higher in the progressive sarcoidosis group compared with the remission group[(10.6±4.6)% vs.(8.68±5.2)%,P<0.01). There were no significant differences between the progressive sarcoidosis group and the remission group with regard to CD4/CD8 T-cell ratio and the expression of angiotensin converting enzyme(ACE) in lung tissue.Non-necrotizing granulomas rate in endobronchial biopsy was 63.6% in the progressive sarcoidosis group,54.9% in the remission group,and 58.4% in the stable group,respectively,without significant difference between three groups(P>0.05) but was significantly different between three groups at the end time of the observation(69.1% vs.12.7% and 36.2%,P<0.05). ConclusionNearly 40% asymptomatic pulmonary sarcoidosis are likely to deteriorate.The increase of TNF-α and BALF neutrophils may indicate the progress of sarcoidosis.
ObjectiveTo improve the knowledge of clinical features,image and pathology of Behcet's disease with the pulmonary artery aneurysm. MethodsOne typical female patient aged 40 years with recurrent pulmonary artery aneurysm caused by Behcet's disease was analyzed including clinical data,image and pathological features.The Pubmed (1967.1 to 2013.10) and Wanfang database (1982.1 to 2013.10) were searched with "Behcet's disease","pulmonary artery aneurysm" as search terms. ResultsRecurrent hemoptysis was major clinical manifestation of pulmonary artery aneurysm caused by Behcet's disease.Features of image including hilar enlargement,pulmonary artery aneurysm and primary thrombus.During the first hospitalization,the patient was diagnosed as pulmonary artery aneurysm.Then pulmonary lobectomy was performed and pathology examination revealed artery aneurysm and primary thrombus.During the second hospitalization,she was diagnosed as pulmonary thromboembolism and it was considered as failure of treatment of anticoagulant therapy.During the third hospitalization,she was diagnosed as pulmonary artery aneurysm of Behcet's disease,and recurrent hemoptysis was fully ameliorated by the combination treatment of glucocorticoid and immunodepressant. ConclusionPulmonary artery aneurysm is the typical feature of pulmonary vascular lesions of Behcet's disease,and recurrent hemoptysis is major clinical manifestation.CT angiography can identify location of pulmonary artery aneurysm.The key drugs of therapy are imunosuppressive drugs in combination with steroids.