Intrathoracic Manifestations of Sarcoidosis: an Imaging Review Highlighting Atypical Features

Abstract

The purpose of this article is to present a more recent radiological review to pulmonologists, radiologists and other clinicians of: typical and atypical manifestations of intrathoracic sarcoidosis, and highlighting its mimic-drug induced sarcoid like reaction. There is an association between immunotherapy and the development of sarcoid-like reactions. Clinicians and radiologists should be aware of this entity. Sarcoidosis is a multisystem inflammatory disease, of unknown etiology that is characterized by non caseating granulomas. It most commonly involves the lungs and lymph nodes. The common features of this entity have been extensively described in literature; however, 25–30% of cases present with atypical features. This review addresses the different manifestations of pulmonary sarcoidosis, highlighting the atypical appearances, which maybe misdiagnosed in the absence of tissue diagnosis. Radiologists should not hesitate to recommend tissue sampling in the setting of atypical findings and for definite diagnosis.