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JK Amorosa. Sarcoidosis Flop. Sarcoidosis , where does the name come from?. Sarc: flesh Oid : like Flesh-like Besnier-Boeck-Schauman Disease. Sarcoidosis–symptoms & findings. Asymptomatic Fatigue Weight loss Aches-pains Arthritis Dry eyes SOB Erythema nodosum Enlarged lymph nodes.

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sarcoidosis where does the name come from
Sarcoidosis, where does the name come from?
  • Sarc: flesh
  • Oid : like
  • Flesh-like
  • Besnier-Boeck-Schauman Disease
sarcoidosis symptoms findings
Sarcoidosis–symptoms & findings
  • Asymptomatic
  • Fatigue
  • Weight loss
  • Aches-pains
  • Arthritis
  • Dry eyes
  • SOB
  • Erythemanodosum
  • Enlarged lymph nodes
  • Rashes
  • Erythemanodosum
  • Hepatomegaly
  • Arrythmias
  • Anemia
  • Nerve palsy
  • Parotid enlargement
  • Abnormal Vitamin D regulation
sarcoidosis pathology
Sarcoidosis - pathology
  • Chronic inflammatory cells: monocytes, macrophages, activated T-lymphocytes form granulomas
  • Systemic inflammatory disease
lofgren syndrome good prognosis
Lofgren Syndrome – good prognosis
  • Bilateral adenopathy
  • Erythema nodosum
  • Arthralgia
imaging summary
Imaging Summary
  • Initial imaging for the diagnosis of sarcoidosis is Chest X-Ray.
  • HRCT can provide better resolution of lung findings
  • Radiographic Stages of disease progression
    • Stage 0: Normal CXR
    • Stage 1: bilateral hilar/mediastinal adenopathy
    • Stage 2: bilateral hilar /med adenopathy and pulmonary opacities
    • Stage 3: Diffuse pulmonary opacities alone
    • Stage 4: Diffuse pulmonary fibrosis
slide7
Paradoxical effect on inflammatory process – ANERGY ? related to increased risk of cancer and infections
  • HYPER Increase inflammation because of increased macrophages, CD4 helper T cell activation
  • HYPO Immune response to antigen challenges such as tuberculin is decreased
what is schauman body
What is Schauman body?
  • Calcium and protein inclusions in Langhans giant cell in a granuloma
imaging characteristics
Imaging characteristics
  • Normal
  • Symmetrical smooth bilateral hilar and mediastinal adenopathy
  • Lung, early stages: perifissural, peribronchial nodules, miliary nodules, patchy focal opacities
  • Lung, late stages: distortion, atelectasis, cavities, bronchiectasis
imaging findings
Imaging Findings
  • Bilateral
  • Peripheral, subpleural/peri- bronchovascular, mid and lower lung zone
  • Basal patches of consolidation
  • migratory
slide24
HRCT
  • Consolidation
  • GG
  • Nodules
  • Reticular pattern
  • Bronchial wall thickening and/or dilitation
  • SPN
  • Perilobular pattern
  • Reverse halo
  • Honeycomb
lung stage iv ddx
Lung, stage IV Ddx:
  • Complicated silicosis
  • Radiation fibrosis
slide52
31 f
  • Describe findings, procedures
slide53
DDX:
  • Lymphoma
  • BAC
  • Chronic Eosinophilic Pneumonia
  • Lung ca
  • Aspiration Pneumonia
  • Lipoid Pneumonia
  • PE
  • Sarcoid
slide54
HRCT
  • Consolidation
  • GG
  • Nodules
  • Reticular pattern
  • Bronchial wall thickening and/or dilitation
  • SPN
  • Perilobular pattern
  • Reverse halo
  • Honeycomb
slide55
DDX:
  • Lymphoma
  • BAC
  • Chronic Eosinophilic Pneumonia
  • Lung ca
  • Aspiration Pneumonia
  • Lipoid Pneumonia
  • PE
  • Sarcoid
references
References
  • H Prabhakar, C Rabinowitz, F Chew AJR. 2008;190: S1-S6. 10.2214/AJR.07.7001
  • G Boitsios et al AJ R 2010;194: W354-W366. 10.2214/AJR.10.4345
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