Sarcoidosis

Question 1

What is seen on CXR in sarcoidosis

Answer 1

Hilar lymphadenopathy

Question 2

What is sarcoidosis

Answer 2

Multisystem grnaulomatous disease -> lungs, heart, brain, kidneys, liver, pancreas

Question 3

CT scan of sarcoidosis
High resolution

Answer 3

Adenopathy
Subcarinal and bilateral hilar nodes
HR -
Multiple tiny nodules in peribronchal vascuar distribution ass w lymphadenopathy
Horizontal fissures beaded with tiny nodules

Question 4

Staging of sarcoidosis

Answer 4

Based on CXRs/CTs
Stage 0 - no changes
Stage 1 - lymphadenopathy
2 - LAP+pulmonary infiltration
3 - pulm infiltration
4 - fibrosis

Question 5

Differentials for bilateral hilar mediastinal lymphadenopathy

Answer 5

Sarcoidosis
TB
Lymphoma
Carcinoma

Question 6

Investigations for sarcoidsosis

Answer 6

CXR/CT scan
Mediastinoscopy - tissue biopsy
Endobronchial US FNA - guiding biopsy - much safer

Question 7

Histological features of sarcoidosis

Answer 7

Non necrotising grnaulomas

Question 8

Treatment of sarcoidosis

Answer 8

Ideally none - comes and leaves quickly
DOnt treat if not affecting QOL or putting end organs at risk

Question 9

How treat sarcoidosis

Answer 9

Steroids if >6 monhts lung function decreased
30mg prednisolone 6 weeks
15mg 6-12 months
Can have long term immunosupression if required

Question 10

Other features of sarcoid

Answer 10

Skin - erythema nodosum
eye - uveitis, nodules conjunctiva
Hypercalacemia
Neuro - seizures, meningeal inflammation, neuropathy
Cardiac - CM, arrhythmias

Question 11

What cells suggest sarcoid

Answer 11

Epithelioid multinucleate giant cells