Case series and literature review of multiple nodular sarcoidosis

Abstract

BackgroundNodular lung disease is a rare presentation of sarcoidosis. Radiologically it can present as multiple pulmonary masses or solitary lung nodule.Case presentationWe report three cases of nodular sarcoidosis in young females of Asian origin who had initially presented with dry cough and worsening dyspnea non-responsive to initially administered antibiotics. Pulmonary nodules were discovered upon radiographic imaging in all three cases which raised concern for the possibility of neoplastic processes. Subsequent biopsies revealed granulomatous inflammation indicative of sarcoidosis. All cases responded very well to systemic corticosteroids.ConclusionSarcoidosis may present as nodular infiltrates which alerts the treating physician to other neoplastic and infectious diseases of the lungs. Appropriate workup may reveal the true nature of this disease and hence, simplify treatment.

Nodular Pulmonary Sarcoidosis

“…Nodular sarcoidosis has favorable prognosis with resolution of radiographic lesions and improvement of clinical picture either with systemic steroids or spontaneously [7]. Our patient received oral steroids for 2 months and follow-up imaging showed resolution of the lung lesions (Fig.…”

Multiple bilateral pulmonary nodules masquerading as pulmonary metastasis; a case of nodular sarcoidosis

“…Sarcoidosis is a granulomatouse disease of unknown etiology that commonly affects young and middle-aged patients between 20 and 40 ( 1 , 3 ). The disease can involve any organ system, but pulmonary involvement occurs in more than 90% of patients.…”

“…The disease can involve any organ system, but pulmonary involvement occurs in more than 90% of patients. Extra-pulmonary involvement, including lymph nodes, skin, eyes, joints, bones, salivary glands, central nervous system, muscles, heart, liver, and spleen also may occur ( 1 , 3 , 4 ). In sarcoidosis, pulmonary involvement occurs in up to 90% of the patients, so the chest X-ray remains a key tool for formulating a diagnosis.…”

“…However, it is more likely to involve some organs than others, and it frequently presents in the lungs (almost 90%) and mediastinal lymph nodes involvement, skin lesions, and ocular disease. Bilateral symmetrical hilar lymphadenopathy, often accompanied by right paratracheal nodes with or without pulmonary infiltrations is the most characteristic radiographic feature of sarcoidosis on chest X-ray ( 2 , 3 ). High resolution computed tomography (HRCT) scans usually show micro nodules with perilymphatic distribution in the early stage of the disease and parenchymal fibrosis in the late stages ( 4 ).…”

“…Nodular sarcoidosis is a rare presentation of pulmonary sarcoidosis that usually manifests as multiple pulmonary nodules (less than 3 cm) or masses (more than 3 cm) on the chest X-ray and CT scan ( 1 , 3 , 5 ). Nodular sarcoidosis has a favorable prognosis, and pulmonary nodules usually resolve spontaneously ( 3 ). Appropriate workup may detect the true nature of pulmonary nodules and, hence, facilitate their treatment.…”