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Mochizuka Y, Enomoto N, Daisuke A, Inoue Y, Yasui H, Hozumi H, Suzuki Y, Karayama M, Furuhashi K, Katsumata M, Hashimoto D, Imokawa S, Fujisawa T, Inui N, Nakamura Y, Tabata K, Johkoh T, Suda T. "Bull's-eye" Sign and Its Longitudinal Change on High-Resolution Computed Tomography in Pulmonary Sarcoidosis. Am J Respir Crit Care Med 2024; 209:e1-e3. [PMID: 37788379 DOI: 10.1164/rccm.202307-1226im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/03/2023] [Indexed: 10/05/2023] Open
Affiliation(s)
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine
- Health Administration Centre, and
| | | | - Yusuke Inoue
- Second Division, Department of Internal Medicine
| | - Hideki Yasui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Yuzo Suzuki
- Second Division, Department of Internal Medicine
| | | | | | - Mineo Katsumata
- Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Dai Hashimoto
- Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Shiro Imokawa
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | | | - Naoki Inui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yutaro Nakamura
- Respiratory and Allergy Medicine, National Hospital Organization Tenryu Hospital, Hamamatsu, Japan
| | - Kazuhiro Tabata
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; and
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Amagasaki, Japan
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Shaikh F, Abtin FG, Lau R, Saggar R, Belperio JA, Lynch JP. Radiographic and Histopathologic Features in Sarcoidosis: A Pictorial Display. Semin Respir Crit Care Med 2020; 41:758-784. [PMID: 32777856 DOI: 10.1055/s-0040-1712534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sarcoidosis is a multisystemic granulomatous disorder that can affect virtually any organ. However, pulmonary and thoracic lymph node involvement predominates; abnormalities on chest radiographs are present in 80 to 90% of patients with sarcoidosis. High-resolution computed tomographic (HRCT) scans are superior to chest X-rays in assessing extent of disease, and some CT features may discriminate an active inflammatory component (which may be amenable to therapy) from fibrosis (for which therapy is not indicated). Typical findings on HRCT include micronodules, perilymphatic and bronchocentric distribution, perihilar opacities, and varying degrees of fibrosis. Less common findings on CT include mass-like or alveolar opacities, miliary opacities, mosaic attenuation, honeycomb cysts, and cavitation. With progressive disease, fibrosis, architectural distortion, upper lobe volume loss with hilar retraction, coarse linear bands, cysts, and bullae may be observed. We discuss the salient CT findings in patients with sarcoidosis (with a major focus on pulmonary features) and present classical radiographic and histopathological images of a few extrapulmonary sites.
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Affiliation(s)
- Faisal Shaikh
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Fereidoun G Abtin
- Department of Radiology, Thoracic and Interventional Section, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Ryan Lau
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Rajan Saggar
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - John A Belperio
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, David Geffen School of Medicine at UCLA, Los Angeles, California
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Herráez Ortega I, Alonso Orcajo N, López González L. El “cúmulo sarcoideo”. Un nuevo signo en tomografía computarizada de tórax de alta resolución. RADIOLOGIA 2009; 51:495-9. [DOI: 10.1016/j.rx.2009.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 05/04/2009] [Accepted: 05/05/2009] [Indexed: 11/16/2022]
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Elicker B, Pereira CADC, Webb R, Leslie KO. Padrões tomográficos das doenças intersticiais pulmonares difusas com correlação clínica e patológica. J Bras Pneumol 2008; 34:715-44. [DOI: 10.1590/s1806-37132008000900013] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 03/05/2008] [Indexed: 01/15/2023] Open
Abstract
A tomografia de alta resolução (TCAR) é a técnica de imagem radiológica que reflete mais de perto as alterações da estrutura pulmonar. Os vários achados tomográficos podem ser combinados para formar padrões típicos. Estes, conjuntamente com a distribuição anatômica dos achados, e com os dados clínicos, podem estreitar o diagnóstico das doenças intersticiais pulmonares difusas, e em vários casos sugerir o diagnóstico correto com alto grau de acurácia. Os padrões mais comuns das doenças intersticiais pulmonares difusas na TCAR são o nodular, linear e reticular, lesões císticas, opacidades em vidro fosco e consolidações. Este artigo revisa as correlações entre os padrões tomográficos na TCAR e os achados patológicos e resume as causas mais comuns e os métodos de investigação para se atingir um diagnóstico nas doenças pulmonares crônicas difusas mais comuns.
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Risbano MG, Groshong SD, Schwarz MI. Lung nodules in a woman with a history of breast cancer. Diagnosis: a sarcoid-like reaction in metastatic breast cancer. Chest 2008; 132:1697-701. [PMID: 17998374 DOI: 10.1378/chest.07-1388] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Michael G Risbano
- Department of Medicine, University of Colorado Health Sciences Center, SOM, Room 5525, 4200 East Ninth Ave, C272, Denver, CO 80262, USA.
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Kim HK, Ban HJ, Chi SY, Chae DR, Cho GJ, Lim JH, Ju JY, Kwon YS, Oh IJ, Kim KS, Kim YI, Lim SC, Kim YC. A Case of Pseudoalveolar Sarcoidosis with Unilateral Pulmonary Infiltration. Tuberc Respir Dis (Seoul) 2008. [DOI: 10.4046/trd.2008.64.2.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jung Ban
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Su Young Chi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Ryeol Chae
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Gye Jung Cho
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jung Hwan Lim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jin Yung Ju
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yong Soo Kwon
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - In Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Kyu Sik Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yu Il Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Chul Lim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Ibn Sellam A, Zahraoui R, Soualhi M, Chaibainou A, Benamor J, Bourkadi JE, Iraqi G. [The pseudoalveolar form of sarcoïdosis: a diagnostic pitfall]. Rev Mal Respir 2006; 23:367-72. [PMID: 17127915 DOI: 10.1016/s0761-8425(06)71605-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Sarcoïdosis is a benign systemic granulomatosis whose aetiology remains unknown. Lung is the most frequently involved organ. The pseudoalveolar form of this disease is known to have an acute onset and is quite uncommon. Therefore, diagnosing such a rare variety of sarcoidosis is rather often challenging. OBSERVATIONS In the present article, the authors report two cases of pseudoalveolar sarcoidosis. The patients, both young adults, showed no suggestive signs of sarcoidosis at first presentation. This resulted in a considerable delay to diagnosis and to the corticosteroid therapy. CONCLUSION The authors emphasize the rarity of the pseudoalveolar form of sarcoidosis. They insist on its roentgenographic characteristics and demonstrate the functional benefits allowed by the precocious medical management. They also propose a current review of the literature.
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Affiliation(s)
- A Ibn Sellam
- Service de Pneumologie, Hôpital Moulay Youssef, CHU Ibn Sina, Rabat, Maroc.
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Maffessanti M, Dalpiaz G. Nodular Diseases. DIFFUSE LUNG DISEASES 2006. [PMCID: PMC7120551 DOI: 10.1007/88-470-0430-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Nóbrega BBD, Meirelles GDSP, Szarf G, Jasinowodolinski D, Kavakama JI. Sarcoidose pulmonar: achados na tomografia computadorizada de alta resolução. J Bras Pneumol 2005. [DOI: 10.1590/s1806-37132005000300012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A sarcoidose é uma doença sistêmica de causa indeterminada, caracterizada por granulomas não-caseosos. Embora possa afetar qualquer órgão, esta doença tem sua morbi-mortalidade relacionada principalmente ao acometimento pulmonar, presente em 80% a 90% dos pacientes. Este artigo ilustra as principais manifestações pulmonares da sarcoidose na tomografia computadorizada de alta resolução, incluindo as formas típicas e atípicas.
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Nakatsu M, Hatabu H, Morikawa K, Uematsu H, Ohno Y, Nishimura K, Nagai S, Izumi T, Konishi J, Itoh H. Large coalescent parenchymal nodules in pulmonary sarcoidosis: "sarcoid galaxy" sign. AJR Am J Roentgenol 2002; 178:1389-93. [PMID: 12034602 DOI: 10.2214/ajr.178.6.1781389] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the large parenchymal nodules in pulmonary sarcoidosis and to describe a new CT sign termed the "sarcoid galaxy." CONCLUSION The CT appearance of pulmonary sarcoidosis suggests that the large nodules arise from a coalescence of small nodules. The large nodules are surrounded by many tiny satellite nodules. These findings were considered to simulate the appearance of a galaxy. This observation was supported by radiologic-pathologic correlation. The sarcoid galaxy sign may be a useful adjunct in the diagnosis of pulmonary sarcoidosis.
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Affiliation(s)
- Masashi Nakatsu
- Department of Radiology and Nuclear Medicine, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Abstract
Pleural sarcoidosis is no longer considered rare, as it occurs in about 3% of all cases of sarcoidosis. However, newer methods of detection may boost this level higher. High-resolution computed tomographic scanning has increased our detection of pleural nodules and pleural thickening. Other manifestations include pneumothorax, chylothorax, and hemothorax. Further studies of large numbers of patients are needed to determine the true prevalence of pleural involvement in sarcoidosis.
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Affiliation(s)
- N T Soskel
- Sarcoidosis Center, Memphis, Tennessee 38119, USA.
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Abstract
Sarcoidosis involves the bronchi or lung in more than 90 percent of patients. Intrathoracic manifestations are protean, ranging from asymptomatic bilateral hilar lymphadenopathy to chronic, progressive, (ultimately fatal), respiratory insufficiency. The clinical course is highly variable, and optimal management and treatment are controversial. We review the salient radiographic, physiologic, and histopathologic features of pulmonary sarcoidosis and discuss rare intrathoracic complications (e.g., bronchostenosis, mycetomas, nodular sarcoidosis, necrotizing sarcoid angiitis and granulomatosis, pulmonary vascular and pleural involvement). We discuss the chest radiographic staging system and the role of ancillary diagnostic modalities including high resolution thin section computed tomographic scans (HRCT), bronchoalveolar lavage, radionuclide scan, and serum angiotensin enzyme converting enzyme. Indications for therapy and an overview of therapeutic options are outlined.
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Affiliation(s)
- J P Lynch
- Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 35-1996. A 57-year-old woman with fever, sweats, neuropathy, and multiple pulmonary nodules. N Engl J Med 1996; 335:1514-21. [PMID: 8890104 DOI: 10.1056/nejm199611143352008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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