SARCOIDOSIS - RECURRENCE OF PRIMARY DISEASE IN TRANSPLANTED LUNGS

PURPOSE: To assess findings of recurrent disease on thin-section computed tomographic (CT) studies and results of bronchoalveolar lavage and transbronchial biopsy (BAL-TBB) procedures performed in adult lung transplant recipients. MATERIALS AND METHODS: Between 1990 and 1993, 32 single-lung, 14 double-lung, and three heart-lung transplantation procedures were performed in 47 patients; 176 thin-section CT scans were reviewed, with a mean follow-up of 18.9 months after transplantation. RESULTS: Sarcoidosis was diagnosed after BAL-TBB of the lung allografts 3 and 15 months after transplantation in both patients without symptoms who received transplants for treatment of sarcoidosis. In one patient, diffuse miliary nodules seen on chest radiographs and thin-section CT scans disappeared after administration of an increased dose of corticosteroids; in the other patient, no radiologic finding of sarcoidosis was present. No recurrence was seen in patients who received transplants for treatment of other diseases. CONCLUSION: Recurrence of primary disease should be considered whenever abnormalities are seen on chest radiographs or thin-section CT scans. Sarcoidosis may recur with or without radiologic findings after transplantation.