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A 24-year-old woman was evaluated because of a three-month history of cough, dyspnea, and weight loss. A chest radiograph revealed nodular pulmonary densities of various sizes and with ill-defined margins (Panel A). The pH was 7.44, the partial pressure of arterial carbon dioxide was 34 mm Hg, and the partial pressure of arterial oxygen was 93 mm Hg while she was breathing ambient air. Lung-biopsy specimens obtained by fiberoptic bronchoscopy revealed noncaseating granulomas with giant cells consistent with a diagnosis of sarcoidosis (Panel B; hematoxylin, phloxine, and safranin O, x100). The patient was lost to follow-up for six months . . . [Full Text of this Article] |