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Vol. 53. Issue 5.
Pages 434-448 (September - October 2011)
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Vol. 53. Issue 5.
Pages 434-448 (September - October 2011)
Update in Radiology
DOI: 10.1016/j.rxeng.2011.03.001
Update thoracic sarcoidosis
La sarcoidosis torácica
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I. Herráez Ortega??
Corresponding author
iherraez@yahoo.es

Corresponding author.
, L. López González
Servicio de Radiología, Complejo Asistencial Universitario de León, León, Spain
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Tables (4)
Table 1. Typical HRTC findings of sarcoidosis.
Table 2. Atypical HRCT findings of sarcoidosis.
Table 3. Areas of cardiac involvement, listed from the most to the least common.
Table 4. Criteria issued by the Japanese Ministry of Health for the diagnosis of cardiac sarcoidosis.
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Abstract

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. It mainly affects the thoracic lymph nodes and the lungs. The staging of sarcoidosis, which classifies patients according to their probability of spontaneous remission, is based on the plain chest film findings. Plain chest films are not as sensitive as high resolution computed tomography (HRCT) at detecting involvement of the lymph nodes, lungs, or bronchi. The high resolution CT findings can be typical, practically pathognomic, or atypical. High resolution CT provides information about the activity of the disease and detects incipient signs of fibrosis and other complications. To reach the diagnosis, it is necessary to correlate the clinical and radiological findings (and often the histological findings).

Cardiac involvement can cause sudden death. The diagnosis of cardiac involvement is difficult; it is based on various imaging tests, such as magnetic resonance imaging, which is more specific, and positron emission tomography. Diagnostic confirmation by endomyocardial biopsy is obtained in few patients.

Keywords:
Sarcoidosis
Diffuse pulmonary disease
High resolution chest computerized tomography
Cardiac sarcoidosis
Resumen

La sarcoidosis es una enfermedad granulomatosa multisistémica de causa desconocida, que afecta principalmente a los ganglios linfáticos torácicos y a los pulmones. La estadificación, que agrupa a los pacientes con similar probabilidad de remisión espontánea, se basa en los hallazgos de la radiografía de tórax, que tiene menor sensibilidad que la tomografía computarizada de alta resolución (TCAR) para detectar la afectación ganglionar, pulmonar y bronquial. Los hallazgos en TCAR pueden ser típicos, prácticamente patognomónicos, o atípicos. La TCAR aporta información sobre la actividad de la enfermedad y detecta incipientes signos de fibrosis y otras complicaciones. Para realizar el diagnóstico es precisa la correlación clínica, radiológica, y en muchos casos anatomopatológica.

La afectación cardiaca puede provocar muerte súbita; el diagnóstico, difícil, se basa en varias pruebas de imagen, como la resonancia magnética, que tiene mayor especificidad, y la tomografía por emisión de positrones; la confirmación mediante biopsia endomiocárdica se obtiene en pocos pacientes.

Palabras clave:
Sarcoidosis
Enfermedad pulmonar difusa
Tomografía computarizada de tórax de alta resolución
Sarcoidosis cardiaca

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