CSW2 sarcoidosis Flashcards
What characterises sarcoidosis?
Non caseating granulomas
What triggers sarcoidosis?
Antigens- there is an antigen specific response
What do granulomas cause in sarcoidosis?
Fibrosis
Chronic disease
How is sarcoidosis diagnosed?
Compatible xray/CT findings
Histology shows non caseating granulomas
Exclusion of alternative diagnoses
What is seen on cxr in sarcoidosis?
Bilateral hilar lymphadenopathy
What skin sign is classically seen in sarcoidosis?
Erythema nodosum
Describe the differences between the 4 stages of sarcoidosis
Stage 1= bilateral hilar lyphadenopathy
Stage 2= “ PLUS parenchymal disease
Stage 3= lymphadenopathy no longer visible, parenchymal disease
Stage 4= fibrosis (trachea may be distorted towards the apex)
Where will the trachea deviate in sarcoidosis and in what stage?
In stage 4 it will deviate towards the area of fibrosis
What is a limitation of cxr in sarcoidosis?
Cannot distinguish between active inflammation, fibrosis and inactive disease
What will look similar to sarcoidosis on cxr?
TB
Lymphoma
Lymphangitis
What diagnostic tests are done to biopsy in sarcoidosis in the different stages? Why are different tests needed?
Stages 1 and 2= EBUS-TBNA
Stage 3 and 4= lavage or endoscopic biopsy
In 3 and 4 lymph nodes arent visible
What occurs in lung vasculature in sarcoidosis often?
Pulmonary hypertension
What is a key complication of sarcoidosis?
Chronic pulmonary aspergillosis
What are some signs of poor prognosis in sarcoidosis?
Irreversible fibrosis
FVC <60%
DLCO <50%
Major airflow obstruction
What are some signs of cardiac sarcoidosis?
Palpitations
Severe dyspnoea (compared to extent of fibrosis)
Syncope/presyncope
Any ECG abnormality
