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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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Jk amorosa

JK Amorosa

Sarcoidosis Flop


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


Sarcoidosis flop
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? related to increased risk of cancer and infections

  • Calcium and protein inclusions in Langhans giant cell in a granuloma


Asteroid body granuloma
Asteroid body related to increased risk of cancer and infections Granuloma


Imaging characteristics
Imaging characteristics related to increased risk of cancer and infections

  • 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


A m 3 19 12
a.m. 3-19-12 related to increased risk of cancer and infections


A m 9 13 11
a related to increased risk of cancer and infections m 9-13-11


Bilateral hilar and mediastinal adenopathy stage ii ddx
Bilateral hilar and mediastinal adenopathy,Stage II, Ddx: related to increased risk of cancer and infections

  • Lymphoma

  • Small cell ca lung

  • TB


Sarcoidosis flop
jf related to increased risk of cancer and infections


Sarcoidosis flop
72 m related to increased risk of cancer and infections


Small cell ca with mediastinal adenopathy and pericardial mets
Small cell ca with related to increased risk of cancer and infections mediastinaladenopathy and pericardial mets


Sarcoidosis
Sarcoidosis related to increased risk of cancer and infections


Imaging findings
Imaging Findings related to increased risk of cancer and infections

  • Bilateral

  • Peripheral, subpleural/peri- bronchovascular, mid and lower lung zone

  • Basal patches of consolidation

  • migratory


Jf adenopathy fine nodular process some along fissures
Jf related to increased risk of cancer and infections Adenopathy, fine nodular process, some along fissures


Sarcoidosis flop
35 f related to increased risk of cancer and infections


Sarcoidosis flop
HRCT related to increased risk of cancer and infections

  • Consolidation

  • GG

  • Nodules

  • Reticular pattern

  • Bronchial wall thickening and/or dilitation

  • SPN

  • Perilobular pattern

  • Reverse halo

  • Honeycomb


Sarcoidosis flop

27 yo f c SOB related to increased risk of cancer and infections


Ddx mets vasculitis sarcoidosis
Ddx related to increased risk of cancer and infections : mets, vasculitis, Sarcoidosis


Sarcoidosis flop

29 yo f c fever related to increased risk of cancer and infections


Sarcoid septic infarcts
Sarcoid related to increased risk of cancer and infections , septic infarcts


Cmv pneumonia
CMV Pneumonia related to increased risk of cancer and infections


Cocaine
cocaine related to increased risk of cancer and infections


Chronic eosinophilic pneumonia
Chronic related to increased risk of cancer and infections eosinophilic pneumonia


Acute hypersensitivity pneumonia
Acute hypersensitivity Pneumonia related to increased risk of cancer and infections


Atoll
Atoll related to increased risk of cancer and infections


Lung stage iv ddx
Lung, stage IV Ddx: related to increased risk of cancer and infections

  • Complicated silicosis

  • Radiation fibrosis


Sarcoidosis flop
jd related to increased risk of cancer and infections .


Sarcoidosis flop
66 related to increased risk of cancer and infections


66 calcified hilar nodes atelectatic bronchiectatic lung changes
66 related to increased risk of cancer and infections Calcified hilar nodes, atelectatic, bronchiectatic lung changes


Dx pmf conglomerate mass
Dx related to increased risk of cancer and infections : PMF, Conglomerate mass


62 f fever
62 f fever related to increased risk of cancer and infections


Fungus ball sarcoid
Fungus ball, related to increased risk of cancer and infections sarcoid


Sarcoidosis flop
31 f related to increased risk of cancer and infections


Sarcoidosis flop
31 f related to increased risk of cancer and infections


Sarcoidosis flop
31 f related to increased risk of cancer and infections


Sarcoidosis flop
31 f related to increased risk of cancer and infections


Sarcoidosis flop
31 f related to increased risk of cancer and infections

  • Describe findings, procedures


Sarcoidosis flop
DDX: related to increased risk of cancer and infections

  • Lymphoma

  • BAC

  • Chronic Eosinophilic Pneumonia

  • Lung ca

  • Aspiration Pneumonia

  • Lipoid Pneumonia

  • PE

  • Sarcoid


Sarcoidosis flop
HRCT related to increased risk of cancer and infections

  • Consolidation

  • GG

  • Nodules

  • Reticular pattern

  • Bronchial wall thickening and/or dilitation

  • SPN

  • Perilobular pattern

  • Reverse halo

  • Honeycomb


Sarcoidosis flop
DDX: related to increased risk of cancer and infections

  • Lymphoma

  • BAC

  • Chronic Eosinophilic Pneumonia

  • Lung ca

  • Aspiration Pneumonia

  • Lipoid Pneumonia

  • PE

  • Sarcoid


Boop polypoid plugs of loose granulation tissue within air spaces
BOOP= related to increased risk of cancer and infections Polypoid plugs of loose granulation tissue within air spaces


References
References related to increased risk of cancer and infections

  • 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