대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Courtesy

H

Definitive Diagnosis

Confirmed by biopsy of lung, lymph node, and skin.

Discussion

The most chacteristic HRCT abnormality in patients with sarcoidosis consists of small nodules that are visible:
1. In the peribronchovascular regions, adjacent to the parahilar vessels and bronchi
2. adjacent to the major fissures
3. in the costal subpleural regions
4. within the interlobular septa
5. in the centrilobular regions.
Nodules visible on HRCT can appear as small as a few millimeters in diameter; they tend to be sharply defined despite their small size. An upper lobe predominance is common.
In sarcoidosis, nodules tend to predominate in the peribronchovascular and subplerual regions; in lymphangitic metastasis, nodules are most frequently septal and peribronchovascular. Septal thickening in patients with sarcoidosis is usually less extensive thant that seen in patients with lymphangitic metastasis and is often associated with distortion of lobular architecture, a finding indicative of fibrosis that is not seen with lymphangitic metastasis. However, these differential features are not helpful in this case.

Keywords

Lung, Interstitial lung disease, Sarcoidosis,