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J Korean Radiol Soc. 2002 Aug;47(2):191-196. Korean. Original Article. https://doi.org/10.3348/jkrs.2002.47.2.191
Nam JE , Ryu YH , Park JG , Choe KO , Im JG , Lee KS , Song KS , Kim HY , Kim SJ .
Department of Diagnostic Radiology, Yonsei University College of Medicine , Research Institute of Radiological Science, Korea. kimydrt@yumc.yonsei.ac.kr
Department of Diagnostic Radiology, Seoul National University College of Medicine and the Institute of Radiation Medicine, Korea.
Department of Diagnostic Radiology, Samsung Medical Center, College of Medicine, Sungkunkwan University, Korea.
Department of Diagnostic Radiology, Asan Medical Center , College of Medicine, University of Ulsan, Korea.
Department of Diagnositic Radiology, National Cancer Centar, Korea.
Abstract

PURPOSE: To determine the specific high-resolution CT features of sarcoidosis in which the observed pattern is predominantly pseudoalveolar. MATERIALS AND METHODS: We retrospectively reviewed the HRCT findings in 15 cases in which chest radiography demonstrated pseudoalveolar consolidation. In all 15, sarcoidosis was pathologically proven. The distribution and characterization of the following CT features was meticulously scrutinized: distribution and characterization of pseudoalveolar lesions, air-bronchograms, micronodules, thickening of bronchovascular bundles and interlobular septa, lung distortion, ground-glass opacities and combined hilar and mediastinal lymphadenopathy. Follow-up CT scans were available in three cases after corticosteroid administration. RESULTS: Between one and 12 (mean, 5.6) pseudoalveolar lesions appeared as dense homogeneous or inhomogeneous opacities 1-4.5 cm in diameter and with an irregular margin located either at the lung periphery adjacent to the pleural surface or along the bronchovascular bundles, with mainly bilateral distribution (n=14, 93%). An air-bronchogram was observed in ten cases. Micronodules were observed at the periphery of the lesion or surrounding lung, which along with a thickened bronchovascular bundle was a consistent feature in all cases. Additional CT features included hilar and mediastinal lymphadenopathy (n=14, 93%), thickened interlobular septa (n=12, 80%), and ground-glass opacity (n=10, 67%). Lung distortion was noted in only one case (7%). After steroid administration pseudoalveolar lesions decreased in number and size in all three cases in which follow-up CT was available. CONCLUSION: The consistent HRCT features of pseudoalveolar sarcoidosis are bilateral multifocal dense homogenous or inhomogenous opacity and an irregular margin located either at the lung periphery adjacent to the pleural surface or along the bronchovascular bundles. Micronodules are present at the periphery of the lesion or surrounding lung. The features are reversible at steroid administration.

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