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Sarcoidosis Flop

JK Amorosa. Sarcoidosis Flop. Sarcoidosis , where does the name come from?. Sarc: flesh Oid : like Flesh-like Besnier-Boeck-Schauman Disease. Sarcoidosis–symptoms & findings. Asymptomatic Fatigue Weight loss Aches-pains Arthritis Dry eyes SOB Erythema nodosum Enlarged lymph nodes.

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Sarcoidosis Flop

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  1. JK Amorosa Sarcoidosis Flop

  2. Sarcoidosis, where does the name come from? • Sarc: flesh • Oid : like • Flesh-like • Besnier-Boeck-Schauman Disease

  3. Sarcoidosis–symptoms & findings • Asymptomatic • Fatigue • Weight loss • Aches-pains • Arthritis • Dry eyes • SOB • Erythemanodosum • Enlarged lymph nodes • Rashes • Erythemanodosum • Hepatomegaly • Arrythmias • Anemia • Nerve palsy • Parotid enlargement • Abnormal Vitamin D regulation

  4. Sarcoidosis - pathology • Chronic inflammatory cells: monocytes, macrophages, activated T-lymphocytes form granulomas • Systemic inflammatory disease

  5. Lofgren Syndrome – good prognosis • Bilateral adenopathy • Erythema nodosum • Arthralgia

  6. Imaging Summary • Initial imaging for the diagnosis of sarcoidosis is Chest X-Ray. • HRCT can provide better resolution of lung findings • Radiographic Stages of disease progression • Stage 0: Normal CXR • Stage 1: bilateral hilar/mediastinal adenopathy • Stage 2: bilateral hilar /med adenopathy and pulmonary opacities • Stage 3: Diffuse pulmonary opacities alone • Stage 4: Diffuse pulmonary fibrosis

  7. Paradoxical effect on inflammatory process – ANERGY ? related to increased risk of cancer and infections • HYPER Increase inflammation because of increased macrophages, CD4 helper T cell activation • HYPO Immune response to antigen challenges such as tuberculin is decreased

  8. What is Schauman body? • Calcium and protein inclusions in Langhans giant cell in a granuloma

  9. Asteroid body Granuloma

  10. Imaging characteristics • Normal • Symmetrical smooth bilateral hilar and mediastinal adenopathy • Lung, early stages: perifissural, peribronchial nodules, miliary nodules, patchy focal opacities • Lung, late stages: distortion, atelectasis, cavities, bronchiectasis

  11. a.m. 3-19-12

  12. am 9-13-11

  13. Bilateral hilar and mediastinal adenopathy,Stage II, Ddx: • Lymphoma • Small cell ca lung • TB

  14. jf

  15. 72 m

  16. Small cell ca with mediastinaladenopathy and pericardial mets

  17. Sarcoidosis

  18. Imaging Findings • Bilateral • Peripheral, subpleural/peri- bronchovascular, mid and lower lung zone • Basal patches of consolidation • migratory

  19. JfAdenopathy, fine nodular process, some along fissures

  20. 35 f

  21. HRCT • Consolidation • GG • Nodules • Reticular pattern • Bronchial wall thickening and/or dilitation • SPN • Perilobular pattern • Reverse halo • Honeycomb

  22. 27 yo f c SOB

  23. Ddx: mets, vasculitis, Sarcoidosis

  24. 29 yo f c fever

  25. Sarcoid, septic infarcts

  26. CMV Pneumonia

  27. cocaine

  28. Chronic eosinophilic pneumonia

  29. Acute hypersensitivity Pneumonia

  30. Atoll

  31. Lung, stage IV Ddx: • Complicated silicosis • Radiation fibrosis

  32. jd.

  33. 66

  34. 66 Calcified hilar nodes, atelectatic, bronchiectatic lung changes

  35. Dx: PMF, Conglomerate mass

  36. 62 f fever

  37. Fungus ball, sarcoid

  38. 31 f

  39. 31 f

  40. 31 f

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