부산대학교 도서관

A 31 year-old electrician was admitted because of mild dyspnea. His occupational history was negative for exposure to Beryllium and/or Asbestos. The chest roentgenogram on admission revealed bilateral diffuse fine nodules, especially in both upper lung fields, which was suggestive of eosinophilic granuloma of the lung. The physical examination results were all within normal limits. Lymph node biopsy from the chest wall as well as the Kveim test showed no granulomatous lesions. There was no elevation of serum ACE.Open lung biopsy revealed many confluent noncaseating granulomas with giant cells in the centers of the lesions. They were usually confined to the subpleural tissue and interlobular septum as well as lung parenchyma on occasion. Elastic stain clearly demonstrated the destructed blood vessels in the lesions, suggesting the presence of vasculitis. Prednisolone was given with prompt improvement of symptoms and chest X-ray findings.The constellation of findings; namely mild symptoms, diffuse nodular shadows, sarcoid like granuloma with necrotizing vasculitis, and good response to the corticosteroid therapy was consistent with the characteristics of NSG previously reported.This case is the first example of NSG reported in Japan.