Describe typical and atypical radiological features of sarcoidosis in chest radiograph and CT and their pathological correlation.
Perform differential diagnosis of pulmonary sarcoidosis to establish diagnostic approach.
Perform sarcoidosis staging on the basis of the chest radiograph.
Sarcoidosis is a systemic granulomatous disease of unknown aetiology.
Although it may involve any organ,
thoracic manifestation is most common and is responsible for most of mortality and morbidity.
Despite high prevalence of pulmonary involvement,
most patients are asymptomatic or present with nonspecific symptoms.
Thus a radiologist plays a vital role in establishing early diagnosis and further management.
Findings and procedure details
Diagnosis of Sarcoidosis
according to the international 1999 consensus,
sarcoidosis should be diagnosed on the basis of correlating clinical symptoms as well as histologic and radiologic findings.
Biopsy should be obtained whenever possible.
Usually transbronchial biopsy is recommended as primary biopsy site.
Biopsy of other affected body regions may be useful,
excluding erythema nodosum which does not contain granulomas.
It should be stressed that histological findings alone are not diagnostic for sarcoidosis.
Similar pathology manifestation can be seen in other granulomatous diseases.
Sarcoidosis is often asymptomatic and clinical presentation in majority of cases is not specific thus a radiologist plays a vital role in its diagnosis.
Sarcoidosis can manifest in a variety of different patterns,
it is necessary to recognize both typical and atypical presentations.
Similar radiological changes may occur in other diseases(Table 3),
hence correlation of imaging features with pathologic findings aid to establish final diagnosis.
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Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High-Resolution CT with Pathologic Correlation.