ORIGINAL ARTICLE
INTEGRATIVE RADIOLOGICAL AND CLINICAL ASSESSMENT OF COUGH IN PULMONARY SARCOIDOSIS USING HIGH-RESOLUTION CT IMAGING

UDK: 616.24-002.7-073.756.8:004

Dimitrijevikj К.

 

University Clinic of Pulmonology and Allergology, Faculty of Medicine- Skopje

 

Abstract:

Introduction:

Sarcoidosis is a systemic inflammatory disease of unknown origin, characterized by the formation of non-caseating granulomas in various organs, most commonly the lungs and lymph nodes. The disease can involve multiple organ systems, leading to a wide range of clinical manifestations. Sarcoidosis is often diagnosed through a combination of clinical presentation, radiological findings, and histopathological evidence of granulomatous inflammation.

The aim of the study is to detect HRCT features of pulmonary sarcoidosis and their correlation with cough.

Material and Methods: In the past two years, fifty patients diagnosed with sarcoidosis were treated at our University Clinic for Pulmonology and Allergology -Skopje. Computed tomography with high resolution was conducted on 128 slice CT scanner PHILIPS INCISIVE, using 1 mm thin-slice thickness and a special reconstruction algorithm.

Results: Cough was present in 80% patients, mostly with low intensity (40%). Micronodular changes (1–3 mm), localized peribronchovascularly in the upper and middle lung zones, were observed significantly less often in patients with cough than in those without cough (10% vs 40%, p=0.041). A statistically significant difference between the cough and no-cough groups was identified in the localization of these changes in the peripheral and subpleural regions (p=0.037). The difference was confirmed between the patients with and without cough in terms of the frequency of hypoattenuation findings in the lower peripheral and subpleural zones.

Conclusion:

High-resolution computed tomography (HRCT) is the preferred imaging modality for evaluating pathological changes in pulmonary sarcoidosis. It provides detailed visualization of characteristic findings, such as lymphadenopathy, micronodules, and other lesions, along with their distribution patterns and any atypical changes. Despite its utility, further research is needed to better understand the mechanisms underlying cough in patients with sarcoidosis.

 

Key words:cough; HRCT; lungs; sarcoidosis.

 

 

References:

  1. Criado E, Sánchez M, Ramírez J, et al. Pulmonary sarcoidosis: Typical and atypical manifestations at high resolution computed tomograhpy with pathologic correlation. RadioGraphics. 2010;30:1567–86. doi: 10.1148/rg.306105512.
  2. Webb WR, Higgins CB. Thoracic imaging. 2nd Edition. Philadelphia: Lippincott Williams & Wilkins; 2011.
  3. Nunes H, Brillet PY, Valeyre D, Brauner MW, Wells AU. Imaging in sarcoidosis. Semin Respir Crit Care Med. 2007;28:102–20. doi: 10.1055/s-2007-970336.
  4. Silva M, Nunes H, Valeyre D, Sverzellati N. Imaging of sarcoidosis. Clin Rev Allergy Immunol. 2015;49(1):45–53. doi: 10.1007/s12016-015-8478-7.
  5. Kovacova E, Buday T, Vysehradsky R, Plevkova  Cough in sarcoidosis patients. Respiratory Physiology & Neurobiology Volume 257, November 2018.
  6. Polychronopoulos VS, Prakash UBS. Airway involvement in sarcoidosis. Chest. 2009;136:1371–1380. doi: 10.1378/chest.08-2569
  7. Tully T, Birring SS. Cough in sarcoidosis. Lung. 2016;194:21–4. doi: 10.1007/s00408-015-9799-2.
  8. Jones RM, Dawson A, Jenkins GH, Nicholson AG, Hansell DM, Harrison NK. Sarcoidosis-related pulmonary veno-occlusive disease presenting with recurrent haemoptysis. Eur Respir J. 2009;34:517–520. doi: 10.1183/09031936.00044609.
  9. Alon EE, Ekbom DC. Neurosarcoidosis affecting the vagus nerve. Ann Otol Rhinol Laryngol. 2010;119:641–645.
  10. Rockoff SD, RohatgiPK: Unusual manifestations of thoracic sarcoidosis. Am J Roengenol 144:513-528, 1985
  11. Criado E, Shanchez M, Ramirez J, Arguis P et al. Pulmonary sarcoidosis: manifestation of high resolution CT with pathologic correlation, chest imaging, 2010, 1567- 1569.
  12. Avital M, Halpern IH, Deeb M, Izbicki G. Radiological findings in sarcoidosis. IMAJ.2008;10: 572-574.
  13. Ortega IH, Gonzales LL. Update thoracic sarcoidosis. Radiologia2011;53(5): 443-448.
  14. Herraez O, Lopez LG: Update thoracic sarcoidosis. Radiologija, Elsevier Doyma, 2011;53: 434-48
  15. Martin SG, Kronek LP, Valeyre D, Brauner N, Brillet PY, Nunes H, et al. High-resolutioncomputed tomography to differentiate chronic diffuse interstitial lung diseases with predominant ground-glass pattern using logical analysis of data.eur Radiol.2010;20:1297- 1310.
  16. KIM JE, Callard RH, King ET JR. Rheumatoid artritis – associated interstitial lung disease. Doi 10.1378/c