A Case Series of Sarcoidosis with Pulmonary Involvement:
Various Clinical and Radiographic Manifestations
Supparerk Disayabutr MD*,
Penvadee Pattanaprichakul MD**, Ruchira Ruangchira-urai MD***
Affiliation :
* Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
** Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Sarcoidosis is a multisystem granulomatous disease of unknown etiology. The disease is rare in East Asian
populations. Patients have many clinical presentations and 90% of patients have pulmonary involvement. There are few
reports in Thailand that collected the data about chest imaging and pathological findings of sarcoidosis.
Material and Method: The data of patient with sarcoidosis with pulmonary involvement, who followed-up between September
2008 and December 2011, were retrospectively reviewed.
Results : Ten patients with sarcoidosis and pulmonary involvement were reviewed. Three patients presented with abnormal
chest x-ray without respiratory symptom or other organ involvement. One patient was suspected to be sarcoidosis secondary
to etanercept therapy. The majority of patients had cutaneous involvement. The most common finding on chest x-ray is
bilateral hilar lymphadenopathy (90%). Seven patients had stage 2 disease and three patients had stage 1 disease. The
diagnoses of all patients were confirmed by histopathology and exclusion of tuberculosis and fungal infection. Spirometry
showed normal in seven patients, irreversible obstruction in one patient, and impaired diffusing capacity in six patients.
There was no indication of systemic corticosteroids or immunosuppressive drug in most patients.
Conclusion : Sarcoidosis has various clinical manifestations. The pulmonary and cutaneous involvement is common and
the diagnosis is made by a combination of clinical, radiological, and histopathologic findings. The treatment of systemic
corticosteroids is not required in most patients. The patients should be regularly followed-up in order to follow the course
of disease.
Keywords : Sarcoidosis, Pulmonary involvement, Granulomatous disease, Non-necrotizing granuloma, Etanercept
All Articles
Download