Radiological aspects of pulmonary sarcoidosis: An integrative review of the literature

Authors

DOI:

https://doi.org/10.33448/rsd-v12i12.44023

Keywords:

Lung; Pulmonary sarcoidosis; Diagnostic imaging; Radiology.

Abstract

Introduction: Sarcoidosis is a multisystemic condition of unknown etiology, characterized by the presence of non-caseating granulomas. Its most common symptoms involve the respiratory system, through coughing, shortness of breath and bronchial hyperreactivity, although it can also present with fatigue, night sweats, weight loss and erythema nodosum. The diagnosis of pulmonary sarcoidosis is more sensitive when performed using computed tomography (CT), allowing the detection of adenopathy and subtle parenchymal changes. The prevalence ranges from less than one case to 40 cases per 100,000 people in the general population, mainly affecting adults under 40 years of age, with a peak incidence in the third decade of life. Objective: To describe the typical forms of pulmonary sarcoidosis using CT, highlighting its importance for the diagnosis of the disease studied. Method: This study is a literature review on the radiological aspects of sarcoidosis based on an active search of bibliography in databases such as Scientific Electronic Library Online (SCIELO), Google Scholar and National Library of Medicine (PubMed MEDLINE), with descriptors “Sarcoidosis”, “Computed Tomography” and “Radiology”. Results: The typical findings found on CT in pulmonary sarcoidosis are nodules, ground-glass opacities, parenchymal opacities, reticular opacities, air trapping, fibrosis, and bronchiectasis. Conclusion: Thoracic sarcoidosis is complex and is often confused with other lung diseases. Severe cases have a major impact, increasing morbidity and mortality. High-resolution tomography is more effective and sensitive in diagnosis. Therefore, radiologists are essential to identify sarcoidosis and reduce risks.

References

Ahmadzai, H., Huang, S., Steinfort, C., Markos, J., Allen, R. K., Wakefield, D., & Thomas, P. S. (2018). Sarcoidosis: a state of the art review from the Thoracic Society of Australia and New Zealand. The Medical Journal of Australia, 208(11), 499–504. doi:10.5694/mja17.00610

Aleksonienė, R., Zeleckienė, I., Matačiūnas, M., Puronaitė, R., Jurgauskienė, L., Malickaitė, R., Strumilienė, E., Gruslys, V., Zablockis, R., & Danila, E. (2017) Relationship between radiologic patterns, pulmonary function values and bronchoalveolar lavage fluid cells in newly diagnosed sarcoidosis. J Thorac Dis. 9(1):88-95. 10.21037/jtd.2017.01.17.

Broos, C. E., van Nimwegen, M., Hoogsteden, H. C., Hendriks, R. W., Kool, M., & van den Blink, B. (2013). Granuloma Formation in Pulmonary Sarcoidosis. Frontiers in Immunology, 4. doi:10.3389/fimmu.2013.00437

Celada, L. J., Hawkins, C., Drake, W. P. (2015) The Etiologic Role of Infectious Antigens in Sarcoidosis Pathogenesis. Clin Chest Med. 36(4):561-8. 10.1016/j.ccm.2015.08.001.

Criado, E., Sánchez, M., Ramírez, J., Arguis, P., de Caralt, T. M., Perea, R. J., & Xaubet, A. (2010). Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High-Resolution CT with Pathologic Correlation. RadioGraphics, 30(6), 1567–1586. 10.1148/rg.306105512

Haramati, L. B., Lee, G., Singh, A., Molina, P. L., & White, C. S. (2001). Newly Diagnosed Pulmonary Sarcoidosis in HIV-infected Patients. Radiology, 218(1), 242–246. 10.1148/radiology.218.1.r01ja

Judson, M. A. (2012). The treatment of pulmonary sarcoidosis. Respiratory Medicine, 106(10), 1351–1361. 10.1016/j.rmed.2012.01.013

Lee, G. M., Pope, K., Meek, L., Chung, J. H., Hobbs, S. B., & Walker, C. M. (2019). Sarcoidosis: A Diagnosis of Exclusion. American Journal of Roentgenology, 1–9. 10.2214/ajr.19.21436

Li Y, Liang Z, Zheng Y, Qiao J, Wang P. Pulmonary sarcoidosis: from clinical features to pathology- narrative review. Ann Palliat Med. 2021 Mar;10(3):3438-3444. 10.21037/apm-21-344.

Lopes, A. C. (2009). Tratado de clínica médica (2a ed.). Roca Editora.

Lopes, A. C. (2015). Tratado de clínica médica (3a ed.). Roca Editora.

Pereira et al. Metodologia da pesquisa científica. UFSM

Nishino, M., Lee, K. S., Itoh, H., & Hatabu, H. (2010). The spectrum of pulmonary sarcoidosis: Variations of high-resolution CT findings and clues for specific diagnosis. European Journal of Radiology, 73(1), 66–73. doi:10.1016/j.ejrad.2008.09.038

Nóbrega, B. B. de, Meirelles, G. de S. P., Szarf, G., Jasinowodolinski, D., & Kavakama, J. I. (2005). Sarcoidose pulmonar: achados na tomografia computadorizada de alta resolução. Jornal Brasileiro De Pneumologia, 31(3), 254–260. https://doi.org/10.1590/S1806-37132005000300012

Palmucci, S., Torrisi, S.E., Caltabiano, D.C. et al. Clinical and radiological features of extra-pulmonary sarcoidosis: a pictorial essay. Insights Imaging 7, 571–587 (2016). https://doi.org/10.1007/s13244-016-0495-4

Patterson, K. C., & Chen, E. S. (2018). The Pathogenesis of Pulmonary Sarcoidosis and Implications for Treatment. Chest, 153(6), 1432–1442. doi:10.1016/j.chest.2017.11.030

Polverino, F., Balestro, E., Spagnolo, P. (2020) Clinical Presentations, Pathogenesis, and Therapy of Sarcoidosis: State of the Art. J Clin Med. 9(8):2363. 10.3390/jcm9082363.

Polverosi, R., Russo, R., Coran, A., Battista, A., Agostini, C., Pomerri, F., & Giraudo, C. (2013). Typical and atypical pattern of pulmonary sarcoidosis at high-resolution CT: relation to clinical evolution and therapeutic procedures. La Radiologia Medica, 119(6), 384–392. 10.1007/s11547-013-0356-x

Sève P, Pacheco Y, Durupt F, Jamilloux Y, Gerfaud-Valentin M, Isaac S, Boussel L, Calender A, Androdias G, Valeyre D, El Jammal T. (2021) Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis. Cells. 10(4):766. 10.3390/cells10040766.

Spagnolo, P., Maier, L. A. (2021) Genetics in sarcoidosis. Curr Opin Pulm Med. 27(5):423-429. 10.1097/MCP.0000000000000798

Spagnolo, P., Rossi, G., Trisolini, R., Sverzellati, N., Baughman, R. P., Wells, A. U. (2018) Pulmonary sarcoidosis. Lancet Respir Med. 6(5):389-402. 10.1016/S2213-2600(18)30064-X.

Spagnolo, P., Sverzellati, N., Wells, A. U., & Hansell, D. M. (2014). Imaging aspects of the diagnosis of sarcoidosis. European Radiology, 24(4), 807–816. 10.1007/s00330-013-3088-3

Tsushima, K., Yokoyama, T., Kawa, S., Hamano, H., Tanabe, T., Koizumi, T., & Kubo, K. (2011). Elevated IgG4 Levels in Patients Demonstrating Sarcoidosis-Like Radiologic Findings. Medicine, 90(3), 194–200. doi:10.1097/md.0b013e31821ce0c8

Vagal, A. S., Shipley, R., & Meyer, C. A. (2007). Radiological manifestations of sarcoidosis. Clinics in Dermatology, 25(3), 312–325. 10.1016/j.clindermatol.2007.0

Veltkamp, M., & Grutters, J. C. (2013). The Pulmonary Manifestations of Sarcoidosis. Pulmonary Sarcoidosis, 19–39. 10.1007/978-1-4614-8927-6_2

Walsh, S. L., Wells, A. U., Sverzellati, N., Keir, G. J., Calandriello, L., Antoniou, K. M., Copley, S. J., Devaraj, A., Maher, T. M., Renzoni, E., Nicholson, A. G. & Hansell, D. M. (2014). An integrated clinicoradiological staging system for pulmonary sarcoidosis: a case-cohort study. Lancet Respir Med. 2(2): 123-30. 10.1016/S2213-2600(13)70276-5. Epub 2014 Jan 15. PMID: 24503267.

Published

15/11/2023

How to Cite

FERREIRA, Ítalo F. .; MAIA, L. D. M. .; MOREIRA, D. F. .; REQUEIJO, M. J. R. . Radiological aspects of pulmonary sarcoidosis: An integrative review of the literature. Research, Society and Development, [S. l.], v. 12, n. 12, p. e75121244023, 2023. DOI: 10.33448/rsd-v12i12.44023. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/44023. Acesso em: 22 nov. 2024.

Issue

Section

Health Sciences