title: Pulmonary sarcoidosis: an update.
abstract: Sarcoidosis is a multisystem disease characterized by the presence of noncaseating granulomas, the exact etiology of which is yet to be determined. Pulmonary involvement occurs in the majority of patients and its severity ranges from asymptomatic involvement of mediastinal lymph nodes to progressive pulmonary fibrosis and chronic respiratory failure that is insensitive to treatment. Diagnosis of pulmonary sarcoidosis requires a compatible clinical picture supported by radiologic and pathologic data. A recent development in establishing the diagnosis of pulmonary sarcoidosis is endobronchial ultrasound that increases the yield of transbronchial needle aspiration of hilar and/or mediastinal lymph nodes. Fluorodeoxyglucose positron emission tomography (FDG-PET) is highly sensitive in detecting occult sites of disease and is of value in guiding biopsies of these sites. A combined imaging modality using both FDG-PET and CT scan is more sensitive than PET alone and is now the standard of care in patients requiring biopsies of active lesions. Biologic agents like anti-tumor necrosis factor antibodies are being used as second line treatment in those patients dependent on steroids or in cases of refractory sarcoidosis. Lung transplantation is the final option in suitable patients with end-stage pulmonary sarcoidosis.
authors: a Division of Pulmonary , New York Medical College, Critical Care & Sleep Medicine , Valhalla , New York , USA.
authors: Vidya
authors: V
authors: Ramachandraiah
authors: b Cardiology Division , New York Medical College, New York Medical College Macy Pavilion , Valhalla , NY , USA.
authors: Wilbert
authors: W
authors: Aronow
authors: c Division of Pulmonary , New York Medical College Medicine, Critical Care & Sleep Medicine , Valhalla , NY , USA.
authors: Dipak
authors: D
authors: Chandy
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Pulmonary sarcoidosis; biologic agents; corticosteroids; lung transplantation; noncaseating granulomas