Abstract
To determine the prevalence of head and neck sarcoidosis (HNS) and evaluate the role of hybrid molecular imaging in HNS. Between 2010 and 2018, 222 patients with chronic sarcoidosis and presence of prolonged symptoms of active disease were referred to FDG PET/CT. Active disease was found in 169 patients, and they were all screened for the presence of HNS. All patients underwent MDCT and assessment of the serum ACE level. Follow-up FDG PET/CT examination was done 19.84 ± 8.98 months after the baseline. HNS was present in 38 out of 169 patients. FDG uptake was present in: cervical lymph nodes (38/38), submandibular glands (2/38), cerebrum (2/38), and bone (1/38). The majority of patients had more than two locations of disease. After FDG PET/CT examination, therapy was changed in most patients. Fourteen patients returned to follow-up FDG PET/CT examination in order to assess the therapy response. PET/CT revealed active disease in 12 patients and complete remission in two patients. Follow-up ACE levels had no correlation with follow-up SUVmax level (ρ = −0.18, p = 0.77). FDG PET/CT can be useful in the detection of HNS and in the evaluation of the therapy response. It may replace the use of non-purposive mounds of insufficiently informative laboratory and radiological procedures.
Highlights
Sarcoidosis is a systemic granulomatous disease of unknown cause
We evaluated 222 patients with chronic sarcoidosis referred for FDG PET/CT examination
The samples were taken from susceptible sites
Summary
Sarcoidosis is a systemic granulomatous disease of unknown cause. The micro-architecture of the granuloma results from CD4 T cell mediated activation of macrophages, which undergo epithelioid transformation and can form multinucleated giant cells. The restriction of the T cell receptor repertoire supports the hypothesis that sarcoidosis is an antigen driven process even though the antigen remains unknown [1,2]. Numerous studies suggest that disease can occur after exposure to pollen or exposure to Mycobacterium tuberculosis. Other studies assume that sarcoidosis causes exposure to some chemicals and insecticides (occupational disease). Some authors believe that disease is genetically predisposed and more frequent in the HLA-B8/A1 gene locus population [1]
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