An autopsy case of sarcoidosis followed up for 27 years, with special reference to pulmonary fibrosis.

An autopsy case of sarcoidosis followed up for 27 years in a 48-year-old woman with pulmonary fibrosis is presented. Chest roentgenography demonstrated an interstitial pneumonia-like pattern with gradual contraction of the upper lobes. Focal and extending fibrosis and hyalinization were observed in various organs including the lung, lymph nodes, heart and liver. Most of the fibrosis was thought to be derived from solitary or confluent granuloma, showing hyalinized nodular, stellate or band-like fibrosis. There was also another type of fibrosis, not derived from granuloma, manifested as fibrosing alveolitis in the lung, and diffuse fibrosis extending throughout the other organs. In the lymph nodes, chromogenic bodies (Hamazaki-Wesenberg bodies) were seen. The process of fibrosis and the significance of chromogenic bodies in cases of chronic sarcoidosis are discussed.