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Immune Restoration Syndrome Manifested by Pulmonary Sarcoidosis

Conrad Wittram1,2, Jane Fogg3 and Harrison Farber4

1 Department of Radiology, Section of Thoracic Radiology, Boston University Medical Center, Atrium 2, 88 E. Newton St., Boston, MA 02118.
2 Department of Radiology, Section of Thoracic Radiology, Massachusetts General Hospital and Harvard University, FND 202, 55 Fruit St., Boston, MA 02114.
3 Dimock Community Health Center, 55 Dimock St., Roxbury, MA 02119.
4 Pulmonary Center, Boston University Medical Center, 715 Albany St., R-304, Boston, MA 02118.



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  		Fig. 1A. —45-year-old woman with pulmonary sarcoidosis as manifestation of immune restoration syndrome. High-resolution CT scan of lungs at level of bronchus intermedius reveals ill-defined small nodular opacities in peribronchovascular and fissural distribution. Small amount of interlobular septal thickening (arrow) is seen.

 


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  		Fig. 1B. —45-year-old woman with pulmonary sarcoidosis as manifestation of immune restoration syndrome. Photomicrograph of histopathologic specimen shows noncaseating tightly formed granulomas and epithelioid histiocytes and lymphocytes. Perilymphatic distribution of granulomas is evident. Normal lung parenchyma and small region of fibrotic interlobular septal thickening (arrow) are seen. (H and E, x125)

 

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