Pulmonary sarcoidosis features

Akira et al. examined initial and follow-up CT scans in 40 patients with pulmonary sarcoidosis (95). Predominantly nodular or multiple large nodules disappeared or decreased in size at follow-up. A conglomeration pattern shrank and evolved into bronchial distortion and decline in FEVi/FVC ratio. Interestingly, GGO and consolidation evolved into honeycombing in some patients. Because sarcoidosis has the potential to evolve over time, initial CT features have limited prognostic value (76). However, certain CT features have predictive value. Focal nodules, alveolar opacities, consolidation, or GGO suggest an active inflammatory component that may reverse with therapy (76,85,96). In contrast, distortion of lung parenchyma, coarse or hnear bands, bronchiectasis, cystic radiolucencies, and bullae reflect irreversible fibrosis (78,79,85,96). 

Due to the rarity of hard metal lung disease, the number of reports describing the thin-section computed tomography (CT) features of this disease is limited. Nevertheless, the pulmonary infiltrates and their distribution pattern are usually better appreciated on a CT examination (Mendelson et al. 1991) (Fig. 11.2). The thin-section CT appearance may be variable and may mimic sarcoidosis (Fig. 11.3),... 

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