Thoracic Sarcoidosis

Radiologic-Pathologic Correlation

Abstract Introduction Clinical Features Pathologic Features

Staging Radiologic Characteristics Complications Extrapulmonary Thoracic Manifestations

Differential Diagnosis Treatment and Prognosis Source Information References

Staging

Because the lungs and thoracic lymph nodes are affected in 90% of patients with sarcoidosis, clinical staging is based on the pattern of chest radiographic findings (8,12) (Figure 6): (a) stage 0, normal chest radiograph; (b) stage I, lymphadenopathy only; (c) stage II, lymphadenopathy and parenchymal disease; (d) stage III, parenchymal disease only; and (e) stage IV, pulmonary fibrosis.

At presentation, approximately 5%-10% of patients have stage 0 disease; 50%, stage I; 25%-30%, stage II; and 15%, stage III (8). Although most cases of sarcoidosis either regress or remain stable, 20% progress to pulmonary fibrosis.

In general, pulmonary function worsens with increasing stage of disease, but staging does not necessarily reflect the severity of pulmonary function abnormalities (3,5,8,13). Often, the radiographic appearance suggests a greater degree of functional impairment than is actually present (9,12).

Abstract Introduction Clinical Features Pathologic Features

Staging Radiologic Characteristics Complications Extrapulmonary Thoracic Manifestations

Differential Diagnosis Treatment and Prognosis Source Information References