Sarcoidosis

Sarcoidosis (from sarc meaning flesh, -oid, like, and -osis, diseased or abnormal condition), also called sarcoid, Besnier-Boeck disease or Besnier-Boeck-Schaumann disease, is a disease in which abnormal collections of chronic inflammatory cells (granulomas) form as nodules in multiple organs.
The cause of sarcoidosis is unknown. Granulomas most often appear in the lungs or the lymph nodes, but virtually any organ can be affected.
Normally the onset is gradual.
Sarcoidosis may be asymptomatic or chronic. It commonly improves or clears up spontaneously.
More than 2/3 of people with lung sarcoidosis have no symptoms after 9 years. About 50% have relapses. About 10% develop serious disability. Lung scarring or infection may lead to respiratory failure and death. Chronic patients may deal with waxing and waning symptoms over many years.

Diagnosis of sarcoidosis is often a matter of exclusion. To exclude sarcoidosis in a case presenting with pulmonary symptoms might involve chest X-ray, CT scan of chest, PET scan, CT-guided biopsy, mediastinoscopy, open lung biopsy, bronchoscopy with biopsy, endobronchial ultrasound and endoscopic ultrasound with FNA of mediastinal lymph nodes(EBUS FNA). Tissue from biopsy of lymph nodes is subjected to both flow cytometry to rule out cancer and special stains (acid fast bacilli stain and Gömöri methenamine silver stain) to rule out microorganisms and fungi. Angiotensin-converting enzyme blood levels are used in diagnosis and monitoring of sarcoidosis.


Chest X-ray changes are divided into four stages
Stage 1 bihilar lymphadenopathy
Stage 2 bihilar lymphadenopathy and reticulonodular infiltrates
Stage 3 bilateral pulmonary infiltrates
Stage 4 fibrocystic sarcoidosis typically with upward hilar retraction, cystic & bullous changes

Number of View: 4296

Leave a comment