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

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.