Giant bullae can occur in patients with sarcoidosis and advanced stages
of the disease, and appear to be bullous emphysema or vanishing lung
syndrome.2,,3,,4,,5 Although emphysema increases in frequency
with age and is found most frequently in patients in the seventh
decade, bullous emphysema is predominantly found in young patients.
Further, the surgical procedures, including lung volume reduction
surgery, are particularly beneficial for those who have bullous
emphysema as well as bullous sarcoidosis.5,,6,,7,,8 Sarcoidosis
should be carefully considered in the differential diagnosis of bullous
emphysema in young patients with chronic airflow limitation (CAL), in
addition to the other hereditary disorders, includingα
1-antitrypsin deficiency, Fabry’s disease, Salla
disease, cutis laxa, and Ehlers-Danlos syndrome.,5 There is
no doubt that sarcoidosis is a cause of bullous emphysema in young
patients with CAL; however, the pathogenesis of large bullae in
patients with sarcoidosis remains to be determined.