Cavity forms of thoracic sarcoidosis (literature review, clinical and radiological observations)

Abstract

Cavity forms of sarcoidosis, which require differential diagnosis with other diseases, manifested by X-ray cavity patterns, polysegmental nodular formations, hilus and mediastinal lymphadenopathy, are extremely rare. The data of the world literature (1973 - 2018) on the studied problem are analyzed, the results of our own clinical and radiological observations of patients (n = 490) with various forms of sarcoidosis are presented. Cavity forms of sarcoidosis were detected in 31 (6.3%) cases — fibrocystic variants in stage IV sarcoidosis (n = 8); sarcoidosis on the background of cystic hypoplasia (n = 7); combined forms of primary cavity sarcoidosis and necrotic sarcoid granulomatosis in 6 (1.2%) patients; a combination of sarcoidosis and fibro-cavernous tuberculosis (n = 5); sarcoidosis with the pattern “reverse halo sign” (n = 5). Examples of our own clinical and radiological observations are presented. The modern methods of multispiral computed tomography have been optimized, the capabilities of the basic post-processing image processing programs have been demonstrated, the use of which significantly increases the sensitivity and specificity of tomographic research.