CT of Pulmonary Sarcoidosis

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 2.00
Procedures: 2.00
Neck and Chest: 2.00

Radiography: 1.00
Procedures: 1.00
Thorax and Abdomen Procedures: 1.00

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Thoracic Section: 2.50

Outline

1. Introduction
2. Epidemiology
3. Clinical Features
4. Pathogenesis
5. Histologic Findings
6. Staging and Prognosis
7. Diagnosis
8. Use of High-Resolution CT
9. Radiologic-Pathologic Correlation
10. Typical Patterns of Lymphadenopathy
11. Atypical Patterns of Lymphadenopathy
12. Typical Parenchymal Manifestations
    1. Micronodules with a Perilymphatic Distribution
    2. Fibrotic Changes
    3. Bilateral Perihilar Opacities
13. Atypical Parenchymal Manifestations
    1. Pulmonary Nodules and Masses
    2. Patchy Airspace Consolidation
    3. Patchy Ground-Glass Opacities
    4. Linear Reticular Opacities
    5. Fibrocystic Changes
       1. Honeycomb-like Cysts
       2. Cavitation of Parenchymal Lesions
       3. Mycetoma Formation
    6. Miliary Opacities
    7. Airway Involvement
       1. Mosaic Attenuation Pattern
       2. Air Trapping
       3. Tracheobronchial Abnormalities
       4. Atelectasis
    8. Pleural Disease
    9. Pleural Plaquelike Opacities
14. Conclusions

Objectives

Upon completion of this course, students will:

1. identify what percentage of sarcoidosis patients develop pulmonary fibrosis
2. be familiar with the initial radiologic test performed when diagnosing sarcoidosis
3. identify how pulmonary sarcoidosis may initially manifest in patients
4. identify the most typical finding of pulmonary involvement in sarcoidosis patients
5. be familiar with organs initially affected by sarcoidosis
6. be familiar with signs and symptoms of sarcoidosis patients
7. identify the skin symptoms exhibited by sarcoidosis patients
8. be familiar with the most common areas of the lungs affected by sarcoidosis
9. identify which patient populations are most affected by sarcoidosis
10. understand the prognosis criteria for patients suffering from sarcoidosis
11. understand what causes epitheliod cell granulomas associated with sarcoidosis
12. be familiar with the proteins created by lymphocytes on the granulomas
13. identify which lobes of the lungs are affected by sarcoidosis
14. be familiar with the diagnostic findings used for sarcoidosis
15. be familiar with the scientist credited for developing the sarcoidosis staging system
16. identify what diagnostic radiological test is used in staging sarcoidosis patients
17. identify the stages of sarcoidosis that are defined under the current system
18. understand the criteria used to stage sarcoidosis
19. be familiar with the remission probability for sarcoidosis
20. identify advances in bronchial imaging
21. describe the technical advantages of high-resolution CT in detecting sarcoidosis
22. understand the ability of high-resolution CT to differentiate forms of sarcoidosis
23. identify the typical pattern of disease on a high-resolution CT when lymphadenopathy is present
24. be familiar with the common cause of bilateral lymph node enlargement in patients
25. identify the prevalent age group for lymphadenopathy
26. be familiar with the perilymphatic distribution of micronodular lesions
27. identify the frequent causes of nodular or irregular thickening of the peribronchovascular interstitium
28. be familiar with the effects of extensive interstitial fibrosis
29. identify the typical parenchymal manifestation of sarcoidosis in patients
30. be familiar with the “galaxy sign” as seen in sarcoidosis patients
31. be familiar with the high-resolution CT sign created by multiple micronodules along lymph vessels
32. identify the patterns associated with atypical patchy airspace consolidations
33. be familiar with the diseases that create patchy airspace consolidations
34. identify the fibrocystic high-resolution CT patterns for sarcoidosis
35. identify the fibrocystic patterns of sarcoidosis that simulate idiopathic pulmonary fibrosis
36. be familiar with the cause of aspergillus that affects some sarcoidosis patients
37. identify the second most common cause of death among patients with sarcoidosis
38. be familiar with the mosaic attenuation pattern seen with high-resolution CT
39. be familiar with the prevalence of pleural effusions and the time to recovery in sarcoidosis patients
40. understand the need for differential diagnosis when patients are suspected of having sarcoidosis