Letter to the Editor
Extensive Endobronchial Lesions in a Patient With Stage 0 Sarcoidosis
Lesiones endobronquiales extensas en un paciente con sarcoidosis en estadio 0
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B: La TC de tórax mostró principalmente bronquiectasias en el lóbulo inferior izquierdo. C-E: La broncoscopia reveló la presencia de lesiones granulosas minúsculas diseminadas, que se extendían de la parte superior de la tráquea a los bronquios segmentarios y subsegmentarios bilaterales, con una distribución circular en todas las partes membranosas y cartilaginosas de las vías aéreas. F: Granulomas de células epitelioides no caseosos.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alban Lovis, Leslie Noirez, Igor Letovanec, Alexandre Walker" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Alban" "apellidos" => "Lovis" ] 1 => array:2 [ "nombre" => "Leslie" "apellidos" => "Noirez" ] 2 => array:2 [ "nombre" => "Igor" "apellidos" => "Letovanec" ] 3 => array:2 [ "nombre" => "Alexandre" "apellidos" => "Walker" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212915001391" "doi" => "10.1016/j.arbr.2015.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001391?idApp=UINPBA00003Z" ] ] "EPUB" => 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"cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Extensive Endobronchial Lesions in a Patient With Stage 0 Sarcoidosis" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "367" "paginaFinal" => "368" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alban Lovis, Leslie Noirez, Igor Letovanec, Alexandre Walker" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Alban" "apellidos" => "Lovis" "email" => array:1 [ 0 => "alban.lovis@chuv.ch" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Leslie" "apellidos" => "Noirez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Igor" "apellidos" => "Letovanec" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Alexandre" "apellidos" => "Walker" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Respiratory Medicine, University Hospital of Lausanne, Lausana, Switzerland" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pathology, Lausanne University Hospital, Lausana, Switzerland" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Lungen- und Schlafzentrum, Lindenhofspital, Bremgartenstrasse, Berna, Switzerland" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones endobronquiales extensas en un paciente con sarcoidosis en estadio 0" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2613 "Ancho" => 1641 "Tamanyo" => 493009 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Lung function tests showing mild obstruction. (B) Chest computed tomography showing mainly bronchiectasis in the left lower lobe. (C)–(E) Bronchoscopy showing miniscule disseminated lesions, spreading from the upper trachea to the segmentary and sub-segmentary bronchi on both sides, with circular distribution in all membranous and cartilaginous parts of the airways. (F) Non-caseating epithelioid cell granulomas.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 61-year-old Causasian man with a history of NYHA grade II dyspnea and unproductive cough lasting several months. He was a former smoker (20 pack-years, with cessation 20 years previously). Lung function tests (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) showed mild obstruction (forced expiratory volume in 1<span class="elsevierStyleHsp" style=""></span>s [FEV<span class="elsevierStyleInf">1</span>] 2.43<span class="elsevierStyleHsp" style=""></span>l, 74% predicted, Tiffeneau index 61%, residual volume [RV] 2.29<span class="elsevierStyleHsp" style=""></span>l, 94% predicted, total lung capacity [TLC] 6.2<span class="elsevierStyleHsp" style=""></span>l, 89% predicted, RV/TLC 37%) and slightly reduced gas exchange (DLCO 53% predicted, KCO 75% predicted, alveolar volume 4.94<span class="elsevierStyleHsp" style=""></span>l, 71% predicted). Chest X-ray was normal (stage 0) and chest CT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B) showed mainly bronchiectasis in the left lower lobe, with no mediastinal or hilar lymphadenopathies. Miniscule disseminated granulomatous lesions spreading from the upper trachea to the segmentary and sub-segmentary bronchi on both sides with circular distribution in all membranous and cartilaginous parts of the airways were observed on bronchoscopy. Lymphocytosis (45%) with a raised CD4/CD8 ratio (4.5) was observed in bronchoalveolar lavage fluid. Non-caseating epithelioid cell granulomas were identified in bronchial biopsy material (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F). Staining and cultures for acid-resistant microorganisms and mycoses were negative.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Extensive endoluminal sarcoidosis with mild parenchymal involvement and no lymph node involvement is very uncommon.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> The treatment of disseminated endoluminal disease is challenging and is aimed at preventing fixed obstruction. Inhaled corticosteroids and bronchodilators were initiated, with clinical and endoscopic monitoring of the patient's progress and lung function.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of Interests</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests with the contents of this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of Interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lovis A, Noirez L, Letovanec I, Walker A. Lesiones endobronquiales extensas en un paciente con sarcoidosis en estadio 0. Arch Bronconeumol. 2015;51:367–368.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2613 "Ancho" => 1641 "Tamanyo" => 493009 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Lung function tests showing mild obstruction. (B) Chest computed tomography showing mainly bronchiectasis in the left lower lobe. (C)–(E) Bronchoscopy showing miniscule disseminated lesions, spreading from the upper trachea to the segmentary and sub-segmentary bronchi on both sides, with circular distribution in all membranous and cartilaginous parts of the airways. (F) Non-caseating epithelioid cell granulomas.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Airway involvement in sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V.S. Polychronopoulos" 1 => "U.B. Prakash" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.08-2569" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2009" "volumen" => "136" "paginaInicial" => "1371" "paginaFinal" => "1380" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19892676" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoscopy in sarcoidosis: diagnostic and therapeutic interventions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.T. Chapman" 1 => "A.C. Mehta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Opin Pulm Med" "fecha" => "2003" "volumen" => "9" "paginaInicial" => "402" "paginaFinal" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12904711" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001391/v1_201506250123/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000007/v1_201506250123/S1579212915001391/v1_201506250123/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001391?idApp=UINPBA00003Z" ]
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