Stage 2 Sarcoidosis

Abstract We present a case of a 50‐year‐old man who presented with progressive shortness of breath, cough, chest pain, and weight loss. His computer tomography (CT) scan of the chest showed a left‐sided pleural effusion, subpleural and peribronchovascular nodules, bilateral hilar and mediastinal lymphadenopaties. Traasbronchial biopsies of the lung parenchyma and Video‐Assisted Thoracoscopic Surgery (VATS) with pleural biopsies revealed the presence of noncaseating granulomas. A diagnosis of stage 2 sarcoidosis with pleural involvement was made and treatment with prednisone was started. The patient continued with persistent dyspnea and a left‐sided pleural effusion. Steroid treatment was tapered and leflunomide therapy was initiated. A significant improvement of his clinical condition was seen after 1 month on treatment