ORIGINAL ARTICLE
HIGH RESOLUTION CT TYPICAL PATTERNS IN PULMONARY SARCOIDOSIS: CORRELATION WITH CLINICAL SYMPTOMS AND RADIOLOGICAL STAGING

UDK:616.24-002.7-073.756.8:004”2022/2023”

Dimitrijevikj K.

 

1University Clinic for Pulmonology and Allergology, Faculty of Medicine-Skopje

 

Abstract:

Introduction: Sarcoidosis is a multisystemic and often chronic disease that can involve nearly any organ. The lungs and intrathoracic lymph nodes are the most commonly affected structures.

The aim: of the study is to classify the stages of sarcoidosis and analyze their correlation with clinical symptoms.

Material and Methods: A total of 50 patients with sarcoidosis came to our University Clinic for Pulmonology and Allergology-Skopje during 2022-2023 period – a retrospective observational study. A high-resolution computed tomography (HRCT) using a 128-slice PHILIPS INCISIVE CT scanner was performed to all patients, using a 1 mm thin-slice protocol optimized for thoracic imaging. Disease staging was conducted according to the Scadding Score System. Clinical symptoms such as smoking, dyspnea and cough were identified from the MOJ TERMIN medical records and compared with the stage of the disease.

Results: The disease stage did not significantly correlate with the patients’ sex and age, but it did significantly correlate with their place of residence. There was a statistically significant difference in the distribution of former smokers across disease stages, driven by the significantly higher proportion of former smokers in stage III compared to stage II. The disease stage had a significant impact on patient hospitalization. The disease stage had a significant impact on the presence of reticular opacities in the upper and middle zones.

 

Key words: HRCT; lungs; sarcoidosis; staging; symptoms.

 

 

References:

  1. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society(ATS) and the European Respiratory Society(ERS). Am J Respir Crit Care Med 2000; 161; 646-664
  2. Hochhegger B, Marchoriori E, Zanon M, et al. Imaging in idiopathic pulmonary fibrosis; diagnosis and mimics. Clinics (Sao Paolo) 2019; 74.
  3. Lynch DA, Sverzellati N, Travis WD, et al. Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society White Paper. Lancet Respir Med 2018;6(2):138-153.
  4. Mohning MP, Richards JC, Huie TJ. Idiopathic pulmonary fibrosis; the radiologists role in making the diagnosis. Br J Radiol 2019;92(1099).
  5. Wuyts WA, Cavazza A, Rossi G, Bonella F, Sverzellati N, Spagnolo P. Differential diagnosis of usual interstitial pneumonia: when is it truly idiopathic? Eur Respir Rev. 2014 Sep;23(133):308-19. doi: 10.1183/09059180.00004914.
  6. Oliviera SD, Filho JAA, Paiva AFL, Ikari ES, Chate RC, Nomura CH. Interstitial pneumonias: review of the latest American thoracic society/European society classification. Radiol Bras.2018 Sept-Oct;5195): 321-32.
  7. Chae JK, Jin YG, Goo MJ, Chung JM. Interstitial lung abnormalities: what radiologists should know: thoracic imaging, Korean J Radiol 2021;22(3): 454-463.
  8. Dhagat PK, Singh S, Jain M, Singh SN, Sharma RK. Thoracic sarcoidosis: imaging with high-resolution computed tomography. J Clin Diagn Res. 2017 Feb;11(2):TC15–TC18. doi: 10.7860/JCDR/2017/24165.9459.
  9. 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.
  10. Baughman RP, Culver DA, Judson MA: A concise review of pulmonary sarcoidosis, Am J Respir Crit Care Med 2011; 183:573-58
  11. Nishino M, Lee KS, Itoh H, et al: The spectrum of pulmonary sarcoidosis: Variations of high- resolution CT findingsand clues for specific diagnosis. Eur J Radiol 2010;73:66-73.
  12. Wilson AG, Hansel DM. immunologic diseases of the lung. In: Armstrong P, Wilson AG, Dee P, Hansell DM, editors. Imaging of the diseases of the chest.3rd ed. NW, London: Mosby; 2000.p. 637-88.
  13. Avital M, Halpern IH, Deeb M, Izbicki G. Radiological findings in sarcoidosis. IMAJ.2008;10: 572-574.
  14. Ortega IH, Gonzales LL. Update thoracic sarcoidosis. Radiologia2011;53(5): 443-448.
  15. Nam HH, Washington A, Butt M, et al. The prevalence and geographic distribution of sarcoidosis in the United States. JAAD Int. 2022 Aug 5; 9:30-32. doi: 10.1016/j.jdin.2022.07.006. PMID: 36089937; PMCID: PMC9449733.
  16. Jindal SK, Singh A, Joshi K, et al. Is tobacco smoking protective for sarcoidosis? A case-control study from North India. Chest 2006;130(4):128S.
  17. Maier LA. Is smoking beneficial for granulomatous lung diseases? Am J Resp Crit Care Med 2004;169(8):893–895.