Sarcoidosis stages I and II - Thoracic Imaging


Title: Thoracic Imaging - Sarcoidosis stages I and II
Diagnosis: Sarcoidosis stages I and II
Author: Martins Martina
Comment: Howarth Nigel
Hospital: HUG
Department: Département de Radiologie
State: Terminée
Date: 21.03.2003
: 3435
KeyWords: Sarcoidosis; adenopathy; granulomatosis
Anatomy: Thorax
Chapter: Mediastinum
ACR: 60.22


Clinical Presentation: Two years after a clinical and bronchoscopicdiagnosis of
stage I sarcoidosis, the patient suffers fromexertional dyspnea and a dry cough.
Comment: Sarcoidosis is a systemic, diffuse granulomatosis ofunknown etiology.
The initial pulmonary lesion is amacrophage-lymphocyte alveolitis. Granulomas appear later
withinthe alveolar wall, along the bronchi, in the pleural space andinterlobular septa. There
are 5 radiological stages in sarcoidosis,relevant to the prognosis: stage 0 ñ normal chest
x-ray stage I -adenopathy without any radiological evidence of pulmonaryinvolvement
stage II - adenopathy associated with pulmonary signsstage III ñ pulmonary disease
without adenopathy stage IV - signsof pulmonary fibrosis
Description: The initial frontal chest X-ray shows bilateralsymmetrical hilar
adenopathy. CT images confirm the presence ofenlarged mediastinal and hilar lymph
nodes. The follow-up chestX-ray two years later shows a new bilateral
perihilarreticulonodular infiltrate and peripheral nodules in the mid-zones.The CT images
show persisting mediastinal and hilar lymph nodeswith subpleural nodules.


Order: 0
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0


References: Lynch JP 3rd, Kazerooni EA, Gay SE. Pulmonarysarcoidosis. Clin
Chest Med. 1997;18:755-85. Newman LS, Rose CS,Maier LA. Sarcoidosis. N Engl J
Med.1997;336:1224-34.

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