Sarcoidosis - Stage IV
Pathophysiology: See Sarcoidosis Stage I
A
progression of the lung disease resulting in predominantly
fibrosis, marked lung architectural distortion, air trapping and
cystic or bullous changes. A form of end stage lung.
CXR/CT Findings:
1.
Marked upper lung fibrosis, distortion
2.
Hilar traction, regional volume loss
3.
Larger cystic or bullous changes
“Aunt Sophies”: a gamut of causes of an end stage
fibrotic lung with upper lung predominance:
-
Post-infectious
granulomatous infections: tuberculosis, fungal infections,
legionella
-
End stage
eosinophilic lung disease rarely
-
COLD with
bronchiectasis with post inflammatory fibrosis and distortion
-
Radiation
pneumonitis if portal involved upper lungs, rarely
-
Silicosis with PMF,
sometimes with superimposed infections and scarring (TB)
-
Immuno-compromised
hosts eg. HIV: post-PCP and other infections
-
Virtually any other
cause of end stage fibrotic lung
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