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Sarcoidosis

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Sarcoid-004.jpg

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[edit] Discussion

  • Of undetermined etiology, sarcoidosis is a chronic noncaseating granulomatous disease that affects multiple organs, but most significantly affects the lungs (90%)and lymphatics (75%). Serious primary complications occur when lung involvement causes restrictive lung disease or when vital structures are involved such as the heart or central nervous system. Patients are often treated with corticosteroids and immunosuppressants and develop secondary complications.
  • Thoracic involvement is staged as follows:
    • Stage 0: Negative chest radiograph
    • Stage 1: Hilar adenopathy
    • Stage 2: Hilar adenopathy plus pulmonary infiltrations
    • Stage 3: Pulmonary infitrations
    • Stage 4: Pulmonary fibrosis

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[edit] Imaging Findings

[edit] Plain films

  • Thoracic Manifestations:
    • Enlarged lymph nodes predominate in the lung hila and right paratracheal region, but can occur elsewhere.
    • Reticular changes develop in the pulmonary interstitium and progress to pulmonary fibrosis.
  • Other Manifestations:
    • Osteolysis of the small bones of the hands and feet are most typical, but permeative destruction can occur. During the healing phase, a sclerotic border may form.

[edit] Computed Tomography

  • High-resolution computed tomography (HRCT) is highly sensitive for the interstitial pulmonary changes in sarcoidosis. Findings range from ground-glass opacity to pulmonary fibrosis. Small nodules in a peribronchovascular distribution are characteristic, but are not pathognomonic.

[edit] Nuclear Medicine

  • Gallium-67 citrate is useful for evaluating patient's with suspected sacoidosis and to evaluate treatment response in patients with known sarcoidosis.
  • More sensitive than chest radiolographs for the detection of early disease.

[edit] Images

[edit] Stage 1

Patient #1

Stage 2

Patient #1

Stage 3

Patient #1

Stage 4

Patient #1: Complicated sarcoid

Non-pulmonary Findings

Patient #1: Osseous sarcoid


[edit] See Also

[edit] External Links

[edit] References