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Article Abstract
A 33-year-old man complaining of cough admitted our hospital for examination of bilateral hilar and mediastinal lymphadenopathy. He diagnosed pulmonary sarcoidosis, because of elevation of serum angiotensin converting enzyme (ACE), epitheloid granuloma with noncaseating necrosis from transbronchial lung biopsy (TBLB) specimen, increasing of lymphocyte and elevation of the CD4/CD8 ratio in bronchoalveolar lavage fluid (BALF). Furthermore, eosinophil ratio in BALF was 3%, hyperplasia of goblet cell, eosinophilic invasion to bronchial epithelium, and thickened basal membrane were found in same biopsy specimen. He had mild reversible airway obstruction. He was diagnosed pulmonary sarcoidosis complicated with bronchial asthma. Sarcoidosis is characteristic of the T helper type 1 (Th1) mediated immune response, and bronchial asthma is characteristic of the Th2. This case histopathologically revealed that both Th1 mediated immune response and Th2 could be coexisted.
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