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Typical and atypical manifestations of intrathoracic sarcoidosis.

Park HJ, Jung JI, Chung MH, Song SW, Kim HL, Baik JH, Han DH, Kim KJ, Lee KY - Korean J Radiol (2009 Nov-Dec)

Bottom Line: The findings include symmetric, bilateral hilar and paratracheal lymphadenopathy, with or without concomitant parenchymal abnormalities (multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium).However, in 25% to 30% of cases, the radiological findings are atypical and unfamiliar to most radiologists, which cause difficulty for making a correct diagnosis.We have collected cases with unusual radiological findings associated with pulmonary sarcoidosis (unilateral or asymmetric lymphadenopathy, necrosis or cavitation, large opacity, ground glass opacity, an airway abnormality and pleural involvement) and describe the typical forms of the disorder as well.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea, Kyunggi-do 442-723, Korea.

ABSTRACT
Sarcoidosis is a systemic disorder of unknown cause that is characterized by the presence of noncaseating granulomas. The radiological findings associated with sarcoidosis have been well described. The findings include symmetric, bilateral hilar and paratracheal lymphadenopathy, with or without concomitant parenchymal abnormalities (multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium). However, in 25% to 30% of cases, the radiological findings are atypical and unfamiliar to most radiologists, which cause difficulty for making a correct diagnosis. Many atypical forms of intrathoracic sarcoidosis have been described sporadically. We have collected cases with unusual radiological findings associated with pulmonary sarcoidosis (unilateral or asymmetric lymphadenopathy, necrosis or cavitation, large opacity, ground glass opacity, an airway abnormality and pleural involvement) and describe the typical forms of the disorder as well. The understanding of a wide range of the radiological manifestations of sarcoidosis will be very helpful for making a proper diagnosis.

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Related in: MedlinePlus

Imaging findings for sarcoid granulomas with perilymphatic distribution are shown.A. High-resolution CT scan shows multiple small nodules in peribronchovascular interstitium (arrow), interlobar fissure (arrowheads) and subpleural region (thin arrows).B. Microscopic image (Hematoxylin & Eosin staining, ×40) reveals non-caseating granulomas with giant cells and proliferating epithelioid cells in bronchovascular interstitium (arrows).
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Figure 3: Imaging findings for sarcoid granulomas with perilymphatic distribution are shown.A. High-resolution CT scan shows multiple small nodules in peribronchovascular interstitium (arrow), interlobar fissure (arrowheads) and subpleural region (thin arrows).B. Microscopic image (Hematoxylin & Eosin staining, ×40) reveals non-caseating granulomas with giant cells and proliferating epithelioid cells in bronchovascular interstitium (arrows).

Mentions: Although sarcoid granulomas are microscopic in size, the lesions often coalesce to form macroscopic nodules. As seen on high-resolution CT (HRCT) images, the nodules appear as small as a few millimeters in diameter and tend to be sharply defined despite a small size. Due to the perilymphatic distribution of sarcoid granulomas, HRCT images typically demonstrate the presence of multiple small nodules predominately in the peribronchovascular interstitium, interlobar fissures and interlobular septae (Fig. 3). The nodules may be distributed throughout both lungs with upper lobe predominance and often are distributed as foci (2-4).


Typical and atypical manifestations of intrathoracic sarcoidosis.

Park HJ, Jung JI, Chung MH, Song SW, Kim HL, Baik JH, Han DH, Kim KJ, Lee KY - Korean J Radiol (2009 Nov-Dec)

Imaging findings for sarcoid granulomas with perilymphatic distribution are shown.A. High-resolution CT scan shows multiple small nodules in peribronchovascular interstitium (arrow), interlobar fissure (arrowheads) and subpleural region (thin arrows).B. Microscopic image (Hematoxylin & Eosin staining, ×40) reveals non-caseating granulomas with giant cells and proliferating epithelioid cells in bronchovascular interstitium (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2770817&req=5

Figure 3: Imaging findings for sarcoid granulomas with perilymphatic distribution are shown.A. High-resolution CT scan shows multiple small nodules in peribronchovascular interstitium (arrow), interlobar fissure (arrowheads) and subpleural region (thin arrows).B. Microscopic image (Hematoxylin & Eosin staining, ×40) reveals non-caseating granulomas with giant cells and proliferating epithelioid cells in bronchovascular interstitium (arrows).
Mentions: Although sarcoid granulomas are microscopic in size, the lesions often coalesce to form macroscopic nodules. As seen on high-resolution CT (HRCT) images, the nodules appear as small as a few millimeters in diameter and tend to be sharply defined despite a small size. Due to the perilymphatic distribution of sarcoid granulomas, HRCT images typically demonstrate the presence of multiple small nodules predominately in the peribronchovascular interstitium, interlobar fissures and interlobular septae (Fig. 3). The nodules may be distributed throughout both lungs with upper lobe predominance and often are distributed as foci (2-4).

Bottom Line: The findings include symmetric, bilateral hilar and paratracheal lymphadenopathy, with or without concomitant parenchymal abnormalities (multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium).However, in 25% to 30% of cases, the radiological findings are atypical and unfamiliar to most radiologists, which cause difficulty for making a correct diagnosis.We have collected cases with unusual radiological findings associated with pulmonary sarcoidosis (unilateral or asymmetric lymphadenopathy, necrosis or cavitation, large opacity, ground glass opacity, an airway abnormality and pleural involvement) and describe the typical forms of the disorder as well.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St. Vincent's Hospital, The Catholic University of Korea, Kyunggi-do 442-723, Korea.

ABSTRACT
Sarcoidosis is a systemic disorder of unknown cause that is characterized by the presence of noncaseating granulomas. The radiological findings associated with sarcoidosis have been well described. The findings include symmetric, bilateral hilar and paratracheal lymphadenopathy, with or without concomitant parenchymal abnormalities (multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium). However, in 25% to 30% of cases, the radiological findings are atypical and unfamiliar to most radiologists, which cause difficulty for making a correct diagnosis. Many atypical forms of intrathoracic sarcoidosis have been described sporadically. We have collected cases with unusual radiological findings associated with pulmonary sarcoidosis (unilateral or asymmetric lymphadenopathy, necrosis or cavitation, large opacity, ground glass opacity, an airway abnormality and pleural involvement) and describe the typical forms of the disorder as well. The understanding of a wide range of the radiological manifestations of sarcoidosis will be very helpful for making a proper diagnosis.

Show MeSH
Related in: MedlinePlus