CT assessment of bronchi in sarcoidosis: endoscopic and pathologic correlations.

Lenique, F; Brauner, M.; Greniér, Philippe; Battesti, J P; Loiseau, Alain; Valeyre, Dominique

doi:10.1148/radiology.194.2.7824721

Cited by 73 publications

(54 citation statements)

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“…Mural thickening, endobronchial involvement, extrinsic compression from enlarged lymph nodes, and architectural distortion of the airway can all lead to bronchial stenosis. Bronchoscopy is a useful tool identifying tracheobronchial stenosis [12,13]. In the present study, bronchial stenosis was found in 57.2% (n=36) of our patients.…”

Section: Discussionsupporting

confidence: 55%

Effects of Lymphadenopathy on Pulmonary Function tests in Sarcoidosis

et al. 2013

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oBJectIVe:The pulmonary function test (PFT) is an important quantification test in the follow-up of sarcoidosis patients. We aimed to investigate the effect of lymphadenopathy (LAP) after controlling pulmonary parenchymal involvement on pulmonary function tests (PFTs) in the context of sarcoidosis. MAterIAl And Methods:A total of 63 sarcoidosis patients were enrolled retrospectively in the study. Respiratory functions were evaluated via PFTs. Radiological evaluations of the patients were made with chest x-ray and high-resolution computerized tomography (HRCT). Bronchoscopic investigations were performed on all patients. Possible factors that affect PFTs were evaluated.resUlts: There was a statistically significant correlation between the bronchoscopic findings and PFTs parameters (p<0.01). Forced vital capacity (FVC) was affected more in the presence of LAP in the adjacent bronchi and, it was similar the same for forced expiratory volume in the first second (FEV 1 ). Considering the grade of HRCT findings, the presence of hilar LAP, intrahilar LAP and lobar LAP had a statistically significant effect on FVC and FEV 1 (p=0.001). conclUsIon:We revealed that in addition to parenchymal involvement of the disease, the special localization of lymph node involvement also has an important effect on the PFTs parameters of sarcoidosis patients. IntrodUctIonSarcoidosis is a multi-systemic disease characterized by noncaseating inflammatory histopathologic findings. It commonly affects lung and mediastinal lymph nodes. Although patients commonly present with pulmonary signs, sarcoidosis may present with all types of organ involvement.Clinical evaluation, chest x-ray, pulmonary function test (PFTs), and high-resolution computerized tomography (HRCT) are important tools in the diagnosis of the disease [1][2][3]. PFTs and HRCT are also important for the followup of the progression and activation of the disease [3][4][5]. In addition to restrictive respiratory dysfunction, obstructive dysfunction can also be observed in sarcoidosis. There is a correlation between PFTs and the stage and prognosis of the disease [2]. Lymph node involvement is present in stages I and II; lung parenchyma involvement of the disease is present in all stages, except stages 0 and I of the disease [6]. There are some studies in the literature showing a relationship between the presence of radiologic findings and PFTs, however, there is no previous study, according to our knowledge, investigating separately the parenchymal involvement and individual lymph node involvement effect on PFTs [2,5].

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Section: Discussionsupporting

confidence: 55%

Effects of Lymphadenopathy on Pulmonary Function tests in Sarcoidosis

et al. 2013

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“…Bronchial involvement, as judged by regular or irregular mural thickening and luminal narrowing, is detected on CT in 65% of patients and is usually concordant with endoscopic findings and endobronchial mucosal granulomas [37]. CT can also demonstrate extrinsic or intrinsic stenosis (see later in this review), traction bronchectasis and bronchial distortion ( fig.…”

Section: Airway Involvementmentioning

confidence: 68%

“…CT as an aid to obtaining biopsy/cytology material There is a clear association between bronchial abnormalities seen on CT and the presence of mucosal granulomas on endobronchial biopsy [37]. Similarly, DE BOER et al [38] recently demonstrated that the total extent of parenchymal disease on CT in addition to the pattern and lobar distribution, i.e.…”

Section: Diagnostic Contribution Of Ctmentioning

confidence: 98%

“…In addition, CT may improve the diagnostic yield of bronchoscopy for obtaining a positive endobronchial [37] or transbronchial biopsy [38] and it is required before endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) [39]. CT findings may discriminate between active inflammation and irreversible fibrosis [40][41][42][43][44], with occasional influence on therapeutic decisions.…”

Section: Chest Radiography As a Guide For Treatment Decisionsmentioning

confidence: 99%

“…Apart from depicting atelectasis and nodal external reduction of bronchial lumen, CT is useful in determining the extent and nature of bronchial stenosis ( fig. 8) [37,108]. However, it cannot replace bronchoscopy, as it leads to false-positive results, incorrectly predicting the presence of focal bronchial abnormalities in up to 14% of patients [37,109].…”

Section: Bronchial Stenosismentioning

confidence: 99%

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Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

et al. 2012

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Imaging has a prominent role in the assessment of sarcoidosis diagnosis and outcome, which are extremely variable. Chest radiography staging helps predict the probability of spontaneous remission, and stage IV is associated with higher mortality. However, the reproducibility of reading is poor and changes in radiography and lung function are inconsistently correlated, which may be problematic for the monitoring of disease and treatment response. Chest computed tomography (CT) makes a great diagnostic contribution in difficult cases. Bilateral hilar lymphadenopathy with peri-lymphatic micronodular pattern is highly specific for sarcoidosis. CT is important for the investigation of pulmonary complications, including aspergilloma and pulmonary hypertension. CT improves the yield of bronchoscopy for obtaining a positive endobronchial or transbronchial biopsy. CT findings may also discriminate between active inflammation and irreversible fibrosis, with occasional influence on therapeutic decisions. Three CT patterns of fibrotic sarcoidosis are identified, with different functional profiles: predominant bronchial distortion is associated with obstruction; honeycombing is associated with restriction and lower diffusing capacity of the lung for carbon monoxide; whereas functional impairment is relatively minor with linear pattern. The clinical impact of correlations between CT severity scores and functional impairment is uncertain, except for its utility elucidating the mechanisms of airflow limitation, which include bronchial distortion, peribronchovascular thickening, air-trapping and bronchial compression by lymphadenopathy.

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