CT Manifestations Of Pulmonary Sarcoidosis

Objective: Sarcoidosis is a multisystem disorder with unkown reason which mayaffect almost any organ. It is in low incidence ratewith diabetes onset which makes ithard to diagnose. The pathology is characterized by nonca-seous epithelioid cellgranulomas. Thoracic involvement is common and accounts for most of themorbidity and mortality associated with the disease. Thoracic radiologicabnormalities are seen at some stage in approximately90%of patients withsarcoidosis, and an estimated20%develop chronic lung disease leading topulmonary fibrosis. So the chest radiography and computed tomography (CT) isoften the first diagnostic imaging study in patients with pulmonary involvement.Pulmonary sarcoidosis may manifest with various radiologic patterns, and often havebeen miss diagnosed. We researched and summarize the features of radiologicmanifestations of56patients with sarcoidosis to achieve a timely andaccuratediagnosis.Materials and methods: We collected the data of59patients who were diagnosed assarcoidosis in clinical of the First Subsidiary Hospital of Guangzhou MedicalCollege from September2004to February2012. All these patientsincluded55inpatients and4outpatients.26patients were male and33patients werefemale. The age were19-69years old with a mean age42.7（±10.3）. Allpatients hadcomplete imaging material and had pathological results of biopsy.20of them werestaging I,25cases were stagingII,11cases were staging III,while there was nostaging IV cases.0thers were the patients with no manifestations in lung.1case only involved with trachea,2cases involved with pleuralwithout performance in lung.Results: The clinical symptom was nonspecific of patients with sarcoidosis. Themain symptomwas cough, sputum, shortness ofbreath and lossing weight. Thesymptomoutside the lungwas common, about18.2%. In the ordinary chest X-rayfilm, some enlargement lymph node or two lung lesions often can’t be shown orcan’t be judged, then it have to check on CT, and give the right diagnosis andstaging to the patients. There were some basical CT in manifestations of pulmonarysarcoidosis.(1) Bilateral hilar and mediastinal lymph node enlargement: lymph nodemainly concentrated in the staging of2,4,5and7lymph node groups. It seems thatthe nodes of patients in staging I had a more number and were much biger than thepatients in staging I. Most of the patients had moderatelyenhancement of lymphnodes, the nonhomegeneous enhancement of lymph nodes were rare(n=3).(2) sarcoidosis in lung: The lung performance of sarcoidosis were complex, such asground—glass opacity, masslike or alveolar opacities, honeycomb-like cysts, miliaryopacities, mosaicattenuation. Most of them showed together,and sometimes one ofthem was main.（3）pleural involvement: Most patients with sarcoidosis had chestwater when the pleural was involvement, and the secondary was pneumothorax，chylothorax or pleural thickening. The pleural thickening could be varied. It couldbe show as nodular thickening, diffuse thickening or local mass.(4) sarcoidosis intrachea bronchial: sarcoidosis involved with the tracheal were rare, but the bronchialwas common. Mainof them werethe thick of tracheal bronchial mucosa,trachealbronchial stenosis and miliary opacitiesin mucosa.Conclusion:The diagnosis of sarcoidosis needs combined with clinical history andother parts image performance. CT play a more important place than X-ray. Theanifestations of sarcoidosis are multiformity, and sometimes the differentialdiagnosis in CT is difficult.