Type:
Educational Exhibit
Keywords:
Thorax, Lung, CT, Conventional radiography, Education, Comparative studies, Inflammation, Pathology
Authors:
C. D. O. Mira1, A. M. D. O. Primitivo2, G. Freire1, M. Ataíde3, J. Calha4; 1Loures/PT, 2Santa Catarina da Serra, PT/PT, 3Lisboa/PT, 4Lisbon/PT
DOI:
10.26044/ecr2019/C-1599
Background
Sarcoidosis is a multisystem chronic inflammatory condition of unknown etiology,
characterized by the presence of non-caseous epithelioid cell granulomas and changes in tissue architecture,
which may affect almost any organ.
Pulmonary manifestations are present in ~ 90% of cases and account for most of the morbidity and mortality associated with the condition.
The clinical picture may include respiratory symptoms such as cough and dyspnoea,
or nonspecific complaints as fatigue,
night sweats,
and weight loss.
In up to 50% of cases,
the patient is asymptomatic,
with abnormalities detected incidentally at chest radiography.
Respiratory function tests usually reveal a restrictive pattern,
with decreased volumes and decreased carbon monoxide diffusing capacity.
The evolution of the disease varies.
Nearly two-thirds of patients remain stable or experience remission within a decade after diagnosis,
with few or no consequences thereafter.
In 20% of cases,
a chronic disease develops,
leading to pulmonary fibrosis.
The variable radiologic manifestations of pulmonary sarcoidosis often provide challenges to radiologists.
They depend on the stage of disease and may be non-specific or atypical in 25-30% of situations.
Recognition of the key features of pulmonary sarcoidosis coupled with knowledge of the underlying pathology can often allow one to make the specific diagnosis.
Imaging also plays a crucial role in evaluating prognosis and monitoring response to therapy.
We review imaging findings of sarcoidosis,
through examples from our institution.