J Korean Med Assoc.  2009 Jan;52(1):41-48. 10.5124/jkma.2009.52.1.41.

Sarcoidosis

• Kim YW

• KMID: 2137732
• DOI: http://doi.org/10.5124/jkma.2009.52.1.41

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology that mainly develops between 25 and 40 years of age and primarily affects the lungs and the lymphatic system. Generally accepted pathogenic hypothesis is that certain environmental agents could promote sarcoidosis in genetically susceptible hosts. The characteristic lesion of sarcoidosis is a noncaseating granuloma that consist of epithelioid cells and T lymphocytes. Diverse clinical courses are observed according to the epidemiologic factors, involved organs, and disease severity. Spontaneous remissions occur in approximately two thirds of patients, but the course is chronic or deteriorative in 10 to 30%. Mortality, ranging between 1 and 5%, is mostly related to progressive respiratory insufficiency, or central nervous system or myocardial involvement. The mainstay of treatment for sarcoidosis is systemic corticosteroid administration. However, the indication, optimal dose, and duration of corticosteroid therapy continue to be controversial.

Keyword

Sarcoidosis; Granuloma; Hilar lymphadenopathy; Corticosteroid

MeSH Terms

Central Nervous System
Epidemiologic Factors
Epithelioid Cells
Granuloma
Humans
Lung
Lymphatic System
Remission, Spontaneous
Respiratory Insufficiency
Sarcoidosis
T-Lymphocytes

Figure

• 

  Figure 1 Chest radiographic staging of sarcoidosis. (A) Stage I. The posteroanterior film shows bilateral hilar lymphadenopathy with clear lung fields. (B) Stage II. The posteroanterior film shows bilateral hilar lymphadenopathy associated with parenchymal infiltration. (C) StageIII.The posteroanterior film shows parenchymal infiltration without hilar lymphadenopathy, but no obvious fibrotic changes. (D) StageIV. The posteroanterior film shows predominantly upper lobe fibrotic abnormalities with hilar retraction, coarse fibrotic masses (mostly on the left), and bibasal compensatory emphysema (secondary to the loss of upper lobe volume).

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  Figure 2 High-resolution computed tomographic section showing widespread micronodules.

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