Primary acute pulmonary cavitation in sarcoidosis

Pk, Rohatgi; Schwab, LE

doi:10.2214/ajr.134.6.1199

Cited by 47 publications

(30 citation statements)

References 11 publications

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“…The men were in the age group of 20–30 years, while the age of women ranged from 25 to 63 years. Six of the eight patients were symptomatic,13–16 while two were diagnosed on routine examination 12 14. Cough was the predominant symptom in 5/6 symptomatic patients,13–16 while dyspnoea was present in 3/6 patients 14–16.…”

Section: Discussionmentioning

confidence: 95%

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Cavitary alveolar sarcoidosis complicated by an aspergilloma

et al. 2014

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SUMMARYCavitation in pulmonary sarcoidosis is rather unusual and even rarer in the alveolar form of the disease. A review of the literature revealed only 13 documented patients with cavitating alveolar sarcoidosis. Of the 13 patients, clinical information was available in only eight cases. Aspergilloma complicating cavitary alveolar sarcoidosis has been documented only once before. A 38-year-old woman with progressive dyspnoea for 3 years presented owing to a bout of haemoptysis. Imaging prior to presentation demonstrated mediastinal lymphadenopathy and coalescent parenchymal alveolar opacities along with air bronchograms, suggestive of alveolar sarcoidosis. On presentation, cavitations were visible in both lungs within the consolidation along with an intracavitary mass in the left upper lobe, which on evaluation was recognised as an aspergilloma. Bronchoscopy disclosed non-caseating granulomas on histopathology confirming pulmonary sarcoidosis. Cavitary alveolar sarcoidosis with aspergilloma formation can result in a diagnostic dilemma, especially in endemic tuberculous areas. BACKGROUND

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Section: Discussionmentioning

confidence: 95%

“…Bilateral hilar lymphadenopathy was present in 6/8 patients 14–16. Solitary cavitary lesions were recorded in four patients12 14 16 while the remaining four had multiple cavities 13–15…”

Section: Discussionmentioning

confidence: 99%

Cavitary alveolar sarcoidosis complicated by an aspergilloma

et al. 2014

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“…Nodular and macronodular patterns are common, and they may be associated with ground-glass opacities or air-space consolidation. Occasionally, nodules may cavitate (17).…”

Section: Discussionmentioning

confidence: 99%

Case 61: Ileocecal Sarcoidosis

Nchimi¹,

Francotte²,

Rausin³

et al. 2003

Radiology

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A 7-year-old boy with no relevant past medical history was admitted for cough and exertional dyspnea. The patient stated that the symptoms started 3 months before and were progressively worsening. He also reported a 2-kg weight loss and intermittent diarrhea during this time. The findings of a physical examination were positive for swelling of the mandibular angle on both sides, tenderness of the right lower quadrant, and decreased breath sounds at the bases of the lungs. When the patient was admitted, his rectal temperature was 97.7°F (36.5°C). Laboratory findings revealed a normal level of serum electrolytes and a normal blood cell count. Serum inflammation markers tested (C-reactive protein and fibrinogen) were not at elevated levels. Posteroanterior chest radiography (Fig 1) and abdominal computed tomography (CT) with 500 mL of orally administered 5% ioxithalamate meglumin (Telebrix Gastro; Guerbet, Aulnay-sous-bois, France) and 100 mL of intravenously administered 300mg/mL iohexol (Omnipaque; Nycomed, Cork, Ireland) (Fig 2) were performed at admission. Gallium 67 ( 67 Ga) whole-body scanning (Fig 3) was performed 24 hours after injection, on the day after admission. IMAGING FINDINGSChest radiography (Fig 1) revealed bilateral diffuse parenchymal air-space and interstitial opacities, as well as peripheral nodules. These findings were predominant in the middle and lower zones of the lungs. There was associated bilateral hilar lymph node enlargement, and lung volumes were normal. Abdominal CT (Fig 2) showed marked symmetric wall thickening of the terminal ileum and cecum, with preserved wall stratification (layers visible). On the day after the patient was admitted and 24 hours after injection, 67 Ga whole-body scintigraphy (Fig 3) revealed marked bilateral and symmetric uptake in the lungs and the parotid and lacrimal glands and moderate uptake in the right hemisphere of the pelvis. The appearance of the skeleton, mediastinum, spleen, and liver was normal.

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“…An infectious etiology is unlikely as repeated sputum cultures failed to grow any pathogens. True primary cavities formed by sarcoid gran ulomas of the walls are extremely rare [5], Additionally, cavities are formed by thick-walled air spaces or air spaces within a fibrotic mass [4], unlike the thin-walled areas evi dent on chest CT. Bronchiectasis may occur due to lung fibrosis, airway obstruction from endobronchial granulo mas or extrinsic compression by lymph nodes. In this patient, normal bronchi were appreciated in the areas adjacent to the cystic lesions, making the diagnosis of cys tic bronchiectasis unlikely.…”

Section: Discussionmentioning

confidence: 99%

Bullous Emphysema Occurring in Pulmonary Sarcoidosis

Zar

Cole²

1995

Respiration

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We describe a rare case of bullous emphysema occurring in a young male with sarcoidosis. The patient had progressive pulmonary symptoms over 14 years. Chest radiology showed bilateral bullae predominantly of both upper and the left lower lobes and mild bronchiectasis. Pulmonary function tests revealed mild restrictive disease and a severe reduction in diffusion capacity. Loss of alveolar surface area due to bullous disease contributes to functional and physiological impairment of lung function in sarcoidosis.

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Primary acute pulmonary cavitation in sarcoidosis

Cited by 47 publications

References 11 publications

Cavitary alveolar sarcoidosis complicated by an aspergilloma

Cavitary alveolar sarcoidosis complicated by an aspergilloma

Case 61: Ileocecal Sarcoidosis

Bullous Emphysema Occurring in Pulmonary Sarcoidosis

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