Learning objectives
To remind well-known radiological manifestations of pulmonary sarcoidosis.
To review diseases that may imitate findings of pulmonary sarcoidosis.
To emphasize importance of clinico-radio-pathological correlation for differential diagnosis.
Background
Sarcoidosis is immune-mediated, multisystemic, chronic inflammatory disease with unknown etiology characterized by non-caseinating granulomas. It is more common between second and fourth decade of life, with female/male ratio favoring slightly female population. Half of patients are clinically asymptomatic. When it is symptomatic, it is mostly manifested by respiratory system involvement .
Pulmonary sarcoidosis is common form which is responsible for most of morbidity/mortality. Radiologic imaging plays important role for evaluation. Chest X-ray and thorax CT are main imaging modalities. Chest X-ray is used for both...
Findings and procedure details
Sarcoidosis is called as great mimicker because it can imitate many diseases both pathologically and radiologically.
1.Pathologic mimickers:
Pulmonary sarcoidosis is characterized by non-caseous granulomas spreading along lymphatics/peribroncovascular region/interlobular septa/subpleural area. Pathological differential diagnoses include other granulomatous lung diseases (Figure 2,14).
2. Radiological mimickers:
2a. Chest X-ray findings and differential diagnoses:
Sarcoidosis is described in 5 stages according to chest radiography findings. This classification is known as Scadding criteria, can be used to determine prognosis of sarcoidosis. However, since CT findings are more sensitive, classification...
Conclusion
Radiological findings of many disease may falsely point out pulmonary sarcoidosis and vice versa. Differential diagnoses of sarcoidosis includes tuberculosis, fungal infections, lymphoproliferative/lymphogranulomatous diseases, malignancies, interstitial/eosinophilic lung diseases, systemic diseases, etc. Although dealing with this long list could be tough, it is necessary to avoid misdiagnosis. In complex cases, more than one patterns may be present and thorough evaluation of all patterns must be done. Because non-supportive findings could be as important as supportive findings for the diagnosis of sarcoidosis (Figure 13). Knowing and considering...
Personal information and conflict of interest
Ö. Önder-Ankara/TR - nothing to disclose//A. Azizova-Ankara/TR - nothing to disclose//G. Durhan-Ankara/TR - nothing to disclose//F. Demirkazik-Ankara/TR - nothing to disclose//M. G. Akpinar-Ankara/TR - nothing to disclose//O. M. Ariyürek-Ankara/TR - nothing to disclose.
References
References are shown in Figure 17.