Radiological Tips on Pulmonary Sarcoidosis Imaging: the Invisible Side of Iceberg's

Abstract

Aim: In our study, we aimed to investigate computed tomography (CT) findings in lung sarcoidosis in the light of different studies in the literature. Material and Methods: Between January 2018 and September 2021, all thorax computed tomography reports were retrospectively scanned in our clinic. The imaging characteristics of 60 patients were examined, whose sarcoidosis findings were defined and diagnosed as sarcoidosis. Results: In the staging of sarcoidosis, 15 (25%) patients were stage I, 42 (70%) patients were stage II, 2 (3.3%) patients were stage III, and 1 (1.7%) patient were stage IV. All our patients with lymph nodes (57 (Stage I and II)) were observed symmetrically. Calcification was present in 5 (8.7%) patients with lymph nodes, and 52 (91.3%) did not have calcification or necrosis. In 6 patients, lymph nodes other than the mediastinum were detected in the axilla and abdomen. When the lymph nodes seen in the axilla and abdomen other than the mediastinum were examined, it was found that the lymph nodes in the mediastinum were larger. In addition, it was determined that the fatty hilus of these lymph nodes, which were detected outside of the mediastinum, could not be distinguished. No accompanying cavitary lesion was observed in any of the lung parenchymal findings. In addition, in 16 (26.6%) patients with parenchymal results, scattered nodules smaller than 1 cm were observed without any other parenchymal conclusion. An increase in peribronchovascular cuffing and peribronchovascular nodular appearances were observed in 20 (33.3%) patients.Discussion: Sarcoidosis is a disease that should always be considered in the differential diagnosis of atypical parenchymal findings in the lung or mediastinal lymph nodes.