The clinical assessment of roentgenographically atypical pulmonary sarcoidosis

Littner, Michael R.; Schachter, E. Neil; Putman, Charles E.; Odero, Dixon; Gee, J. Bernard L.

doi:10.1016/0002-9343(77)90833-6

Cited by 39 publications

(21 citation statements)

References 21 publications

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“…Radiographic findings are atypical in approximately 20% of cases [8,9] and are more frequent in patients over the age of 50 yrs [10]. CT is of considerable aid when radiographic presentation is atypical and not immediately diagnostic, as discussed later in this article.…”

Section: Radiographic Featuresmentioning

confidence: 96%

“…Apparent pleural thickening often represents inward retraction of extrathoracic soft tissue and extrapleural fat, rather than a true pleural abnormality. Pleural involvement is rare in sarcoidosis, with pleural effusions observed in less than 5% of patients on chest radiography [7,8] and in 2.8% on ultrasonography [92]. In CT studies, pleural surface thickening is evidenced in 11-33% of patients [40,42,70] and a mild effusion in 8.2% [93].…”

Section: Pleural Involvementmentioning

confidence: 99%

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Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

et al. 2012

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Imaging has a prominent role in the assessment of sarcoidosis diagnosis and outcome, which are extremely variable. Chest radiography staging helps predict the probability of spontaneous remission, and stage IV is associated with higher mortality. However, the reproducibility of reading is poor and changes in radiography and lung function are inconsistently correlated, which may be problematic for the monitoring of disease and treatment response. Chest computed tomography (CT) makes a great diagnostic contribution in difficult cases. Bilateral hilar lymphadenopathy with peri-lymphatic micronodular pattern is highly specific for sarcoidosis. CT is important for the investigation of pulmonary complications, including aspergilloma and pulmonary hypertension. CT improves the yield of bronchoscopy for obtaining a positive endobronchial or transbronchial biopsy. CT findings may also discriminate between active inflammation and irreversible fibrosis, with occasional influence on therapeutic decisions. Three CT patterns of fibrotic sarcoidosis are identified, with different functional profiles: predominant bronchial distortion is associated with obstruction; honeycombing is associated with restriction and lower diffusing capacity of the lung for carbon monoxide; whereas functional impairment is relatively minor with linear pattern. The clinical impact of correlations between CT severity scores and functional impairment is uncertain, except for its utility elucidating the mechanisms of airflow limitation, which include bronchial distortion, peribronchovascular thickening, air-trapping and bronchial compression by lymphadenopathy.

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Section: Radiographic Featuresmentioning

confidence: 96%

Section: Pleural Involvementmentioning

confidence: 99%

Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

et al. 2012

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“…The first case was reported in 1952 by McCord & Hyman. Since then a few reports of this X-ray pattern have been published usually in women and blacks (Felson, 1959;Sharma et al, 1973;McCord & Hyman, 1952;Kirks et al, 1973;Littner et al, 1977;Dhakhwa et al, 1976). Its frequency in the different series varies from 0 to 4% ' (Mayock et al, 1963;Sharma et al, 1973).…”

Section: Case Reportmentioning

confidence: 99%

“…The parenchymal infiltrations seen in stages II and III appear in a variety ofpatterns. The pulmonary densities are almost bilateral and may be reticulonodular or confluent, or may present as multiple large densities simulating metastatic carcinoma (Littner et al, 1977).…”

Section: Case Reportmentioning

confidence: 99%

Sarcoidosis presenting as multiple pulmonary nodules and nephrotic syndrome

Vidal

Oliver

Campanya

et al. 1986

Postgraduate Medical Journal

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Summary:A 56 year old man presented with thrombophlebitis, nephrotic range proteinuria and multiple pulmonary nodules. A renal biopsy showed membranous glomerulonephritis, and after a thoracotomy a diagnosis of sarcoidosis was established.A pulmonary nodular pattern is unusual in sarcoidosis and is often mistaken for malignant disease. The association of this type of pulmonary involvement and membranous glomerulonephritis as the presenting form of sarcoidosis has not previously been described.

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“…Atypical radiographic presentations include unilateral lung or lobar infiltrates, unilateral lymphadenopathy, and predominant upper-lobe involvement. [33][34][35][36] Upper-lobe involvement simulating pulmonary tuberculosis was found in 54 of 616 patients (9 percent) at one institution and was often unilateral. 33 Other findings mimicking those in tuberculosis were opacification and shrinkage of the upper lobes and bullae of varying size.…”

Section: Ifferential D Iagnosismentioning

confidence: 99%