Bullectomies for bullous sarcoidosis.

A 36-year-old woman presented with respiratory insufficiency due to cystic sarcoidosis. She had been previously treated with multiple courses of prednisone without improvement. Enlarging blebs involving both lower lobes impaired the function of the relatively spared upper lobes. Bilateral lower lobectomies were performed in one step via median sternotomy without complications, with prompt subjective and objective improvement of her respiratory status. One-stage bilateral upper-lobe bullectomy for bullous emphysema has been previously reported, but to our knowledge this is the first performance of one-stage bilateral lower-lobe bullectomies for cystic sarcoidosis. The immediate benefits were evident; long-term results will depend on the course of the underlying disease.