Pulmonary Sarcoidosis

A comprehensive overview of sarcoidosis covering subjects like symptoms, diagnostics, research, causes and pictures
Pulmonary Sarcoidosis

Pulmonary sarcoidosis

     Pulmonary radiography - is the main element from which goes for most patients the diagnosed with pulmonary sarcoidosis. On the chest radiography it can be seen the enlarged chest lymph nodes and the changes which appear in the lungs (usually small nodules). On its base a staging of the disease is made: stage 0, I, II, III, and IV. This classification of the disease on radiological criteria has the advantages of being universally known, providing an easy communication and to provide a general guide to the prognosis.

     Respiratory function tests - are essential for assessing the lung function at the pulmonary sarcoidosis diagnosis, determining the criteria for treatment, detection of the severe or the atypical forms (blocking the airways). These tests measure how the lungs are functioning. For this measurement is required that the patient to blow into a device. The degree of decline of the pulmonary function reflects the severity of the disease.

     Bronchoscopy - is an investigation in which a tube is inserted through the mouth provided with an optical system that sees what's happening in the trachea and in the bronchi (the airways). This test is performed under local anesthesia (by inhalation). During bronchoscopy, after viewing the trachea and the bronchi it can be performed several maneuvers to put the diagnostic for pulmonary sarcoidosis:

  • bronchial biopsy: picking a small piece of the bronchial wall for examination under a microscope
  • transbronchial biopsy: the passage of a needle through the bronchial wall in a loop or even in the lung in order to collect a small piece
  • broncho-alveolar lavage: it is inserted into the lung a small amount of saline that is recovered and analyzed under a microscope

     Angiotensin converting enzyme - is an enzyme that is measured in blood and is usually with elevated values in patients with pulmonary sarcoidosis. These values change during treatment. It is important to know that some patients with pulmonary sarcoidosis may have normal levels of ACE. Its level may be increased in other diseases (tuberculosis, lymphoma, occupational diseases). It is useful for monitoring the evolution in patients who were initially with high values, especially in those with severe extra pulmonary condition.

     CT scan - it is not a necessary routine to sarcoidosis, being indicated in special cases: atypical radiographs, atypical symptoms, and complications. It contributes to the assessment of the extent of lesions and in determining the prognosis.

     Tuberculin test - is negative. Tuberculin is a protein extract from a culture of tubercle bacilli.

     Kweim test- is the most specific test for pulmonary sarcoidosis, giving false positive results in only 0.7-2% of healthy subjects. It involves inoculating a suspension of sarcoid tissue (tissue extract) and microscopic examination after 4-6 weeks of the area in which the suspension was introduced. In patients with sarcoidosis, to the microscope is observed specific granulomas. The disadvantages of this test are: it is difficult to prepare it and to standardize; moreover, is charged with possible transmission of infectious agents.

     Bioassays - shows signs of nonspecific inflammation: increased ESR, increased C reactive protein.

     Determination of calcium in blood and urine - sometimes these values are high, because granulomas secrete vitamin D which increases the calcium absorption from the gut.

     Histopathological examination - is made in a laboratory after different biopsy fragments and provides a diagnosis of certainty. Biopsy may be performed from the peripheral lymph, from skin, from lymph from the thorax, from the lungs. Node biopsy from the chest and lung biopsy can be performed via bronchoscopy or surgical way (mediastinoscopy, open chest lung biopsy). Microscopic examination of the tissue fragments are made in order to exclude other diseases that can cause changes similar to pulmonary sarcoidosis and establish with certainty the diagnosis of sarcoidosis.

Pulmonary sarcoidosis pictures and images

pulmonary sarcoidosis picture

pulmonary sarcoidosis pic

      Within the USA, pulmonary fibrosis is thought to be the leading reason behind demise due to sarcoidosis because it carries a mortality rate of 1% to 5%. Different problems of pulmonary sarcoidosis embody bronchiectasis, mycetomas, pulmonary hypertension, pleural effusions, endobronchial stenosis, and, not often, bullous lung disease. Despair, power pain syndromes that can resemble with fibromyalgia, and also sleep apnea can be prevalent in patients with sarcoidosis.