Article Text

Unusual presentation of more common disease/injury
Keep an eye on the lung
  1. Atef Michael1,
  2. Kushal Pujara2,
  3. Paul Beckett2
  1. 1
    Russells Hall Hospital, Geriatric Medicine Department, Bensenett Road, Dudley, DY1 2HQ, UK
  2. 2
    Queen’s Hospital, Belvedere Road, Burton on Trent, Staffordshire, DE13 0RB, UK
  1. Atef Michael, a.michael3{at}


The case of a 42-year-old man, originally seen in the Ophthalmology clinic after his wife noticed his pupil sizes were different, is presented. He had been feeling tired with lack of energy for 6 months, during which time he had lost about 6.4 kg in weight. Then he started to have night sweats and a non-productive cough. His appetite was good. A chest x ray showed right midzone and some left lung opacities. Thoracic high-resolution CT showed patchy consolidation involving both midzones with widespread nodular shadowing. Transbronchial biopsies showed non-caseating epitheloid cell granulomata consistent with sarcoidosis.

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  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.