Chest
Nodular Sarcoidosis: An Unusual Radiographic Appearance
Section snippets
CASE 1
This 31-year-old Negro woman was admitted in May, 1970, with a two-week history of swelling and pain about the eyes, with an associated dry gritty feeling. She complained also of weakness, anorexia, night sweats, and a nonproductive cough. A nonpruritic right-sided facial rash had been present for a few days. Physical examination findings were normal, apart from bilateral lacrimal gland enlargement. A chest roentgenogram showed bilateral hilar adenopathy and numerous discrete nodules (Fig 1).
COMMENT
The varied radiologic appearances of sarcoidosis have been classified into four stages:
Stage 0–normal chest x-ray film
Stage 1–bilateral hilar lymph node enlargement
Stage 2–bilateral hilar lymph node enlargement with parenchymal infiltration
Stage 3–diffuse pulmonary infiltration without hilar adenopathy; this latter group, coalescing with a far advanced roentgenographic appearance of extensive pulmonary fibrosis with bullae formation. Atypical patterns are rare, well described in detail by
REFERENCES (5)
Uncommon roentgen patterns of pulmonary sarcoidosis.
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Sarcoidosis, typical and atypical thoracic manifestations and complications.
Clin Radiol
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Cited by (48)
Sarcoidosis presenting as a solitary pulmonary mass
2020, Respiratory Medicine Case ReportsReprint of: The pathology of pulmonary sarcoidosis: update
2018, Seminars in Diagnostic PathologyCitation Excerpt :The most common concept of the pathogenesis of NSG is that it represents a variant of sarcoidosis and possibly the morphologic underpinning of so-called nodular sarcoidosis (NS).40,42 Nodular sarcoidosis is rare, varying from 1.6% to 4% of patients with sarcoidosis.58–60 McCord and Hyman61 in 1952 were the first to report that large pulmonary nodules occurred in sarcoid patients, but it was Sharma and associates58 who initially used the term “nodular sarcoidosis” in a report of six cases.
Chest Imaging
2015, Clinics in Chest MedicineCitation Excerpt :Sarcoid nodules can aggregate into pulmonary nodules (not >3 cm in diameter) or large masses. Such a presentation is uncommon in sarcoidosis and estimated as 2.4% to 4%.17,25,33–35 In a retrospective analysis of African American patients, 82% had multiple masses/nodules and only 18% had a solitary lesion.36
A patient with sarcoidosis who developed heterochronic involvements in different organs from initial organs during 7 years
2014, Respiratory InvestigationCitation Excerpt :In our case, multiple pulmonary nodules were seen. The prevalence of this form of sarcoidosis is estimated at 2.4–4% [13,14]. In 1952 McCord and Hyman [15] reported the first two cases of pulmonary sarcoidosis with the radiologic appearance of metastatic cancer and there have been several case reports since then.
The pathology of pulmonary sarcoidosis: update
2007, Seminars in Diagnostic PathologyCitation Excerpt :Nodular sarcoidosis is rare, varying from 1.6% to 4% of patients with sarcoidosis.58-60 McCord and Hyman61 in 1952 were the first to report that large pulmonary nodules occurred in sarcoid patients, but it was Sharma and associates58 who initially used the term “nodular sarcoidosis” in a report of six cases. Nodular sarcoidosis, as the name suggests, shows nodules of coalescent granulomas.
The pseudoalveolar form of sarcoïdosis: A diagnostic pitfall
2006, Revue des Maladies Respiratoires
Assistant Professor of Medicine.
Barlow Fellow in Pulmonary Disease.
Assistant Professor of Radiology. Supported in part by California Research Medical Education Fund of the Tuberculosis and Respiratory Disease Association of California