Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure
Background: There is currently no consensus on the morphology of severe fibrotic pulmonary sarcoidosis, and we examined computed tomography (CT) findings and progression. Methods: We analyzed findings in 10 consecutive patients (three men, seven women) with pulmonary sarcoidosis requiring oxygen the...
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doaj-0ee1d8aeff9f4d4e82c148171ae631692020-11-25T01:38:34ZengMDPI AGJournal of Clinical Medicine2077-03832020-01-019114210.3390/jcm9010142jcm9010142Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory FailureMichiru Sawahata0Takeshi Johkoh1Takeshi Kawanobe2Chiyoko Kono3Yosikazu Nakamura4Masashi Bando5Koichi Hagiwara6Tamiko Takemura7Fumikazu Sakai8Noriharu Shijubo9Satoshi Konno10Tetsuo Yamaguchi11Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke 329-0498, JapanDepartment of Radiology, Kansai Rosai Hospital, Amagasaki 660-8511, JapanDepartment of Respiratory Medicine, JR Tokyo General Hospital, Shibuya 151-8528, JapanDepartment of Respiratory Medicine, JR Tokyo General Hospital, Shibuya 151-8528, JapanDepartment of Public Health, Jichi Medical University, Shimotsuke 329-0498, JapanDivision of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke 329-0498, JapanDivision of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke 329-0498, JapanDepartment of Pathology, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, JapanSaitama Medical University International Medical Center, Department of Radiology, Hidaka 350-1298, JapanDepartment of Respiratory Medicine, JR Sapporo Hospital, Sapporo 060-0033, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-0808, JapanDepartment of Respiratory Medicine, Shinjuku Tsurukame Clinic, Shibuya 151-0053, JapanBackground: There is currently no consensus on the morphology of severe fibrotic pulmonary sarcoidosis, and we examined computed tomography (CT) findings and progression. Methods: We analyzed findings in 10 consecutive patients (three men, seven women) with pulmonary sarcoidosis requiring oxygen therapy for chronic respiratory failure, who were extracted from >2500 sarcoidosis patients (three hospitals, 2000−2018). Patients with comorbidities causing chronic respiratory failure were excluded. Results: Predominant findings were consolidations along the bronchovascular bundles comprising ‘central-peripheral band’, traction bronchiectasis, peripheral cysts/bullae, and upper lobe shrinkage. Traction bronchiectasis arose from opacities comprising ‘central-peripheral band’. Clustering of traction bronchiectasis at the distal side formed honeycomb lung-like structures in three patients. Upper lobe shrinkage progressed in seven patients together with progression of consolidations, ‘central-peripheral band’, traction bronchiectasis clusters, and cysts, while patients without shrinkage included two patients with severe multiple cysts without traction bronchiectasis. Restrictive ventilatory impairment developed in most patients. Pulmonary hypertension (PH) was detected radiologically in five patients, and chronic progressive pulmonary aspergillosis (CPPA) in four patients. Conclusions: During progression, consolidations comprising ‘central-peripheral band’ progressed together with traction bronchiectasis clusters and peripheral cysts, resulting in upper lobe shrinkage. This may lead to respiratory failure with possible complications such as PH and CPPA.https://www.mdpi.com/2077-0383/9/1/142sarcoidosisfibrosisupper lobe shrinkagetraction bronchiectasishoneycomb lungcystconsolidationchronic respiratory failurehome oxygen therapyhilar mediastinal lymphadenopathy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michiru Sawahata Takeshi Johkoh Takeshi Kawanobe Chiyoko Kono Yosikazu Nakamura Masashi Bando Koichi Hagiwara Tamiko Takemura Fumikazu Sakai Noriharu Shijubo Satoshi Konno Tetsuo Yamaguchi |
spellingShingle |
Michiru Sawahata Takeshi Johkoh Takeshi Kawanobe Chiyoko Kono Yosikazu Nakamura Masashi Bando Koichi Hagiwara Tamiko Takemura Fumikazu Sakai Noriharu Shijubo Satoshi Konno Tetsuo Yamaguchi Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure Journal of Clinical Medicine sarcoidosis fibrosis upper lobe shrinkage traction bronchiectasis honeycomb lung cyst consolidation chronic respiratory failure home oxygen therapy hilar mediastinal lymphadenopathy |
author_facet |
Michiru Sawahata Takeshi Johkoh Takeshi Kawanobe Chiyoko Kono Yosikazu Nakamura Masashi Bando Koichi Hagiwara Tamiko Takemura Fumikazu Sakai Noriharu Shijubo Satoshi Konno Tetsuo Yamaguchi |
author_sort |
Michiru Sawahata |
title |
Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure |
title_short |
Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure |
title_full |
Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure |
title_fullStr |
Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure |
title_full_unstemmed |
Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure |
title_sort |
computed tomography images of fibrotic pulmonary sarcoidosis leading to chronic respiratory failure |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-01-01 |
description |
Background: There is currently no consensus on the morphology of severe fibrotic pulmonary sarcoidosis, and we examined computed tomography (CT) findings and progression. Methods: We analyzed findings in 10 consecutive patients (three men, seven women) with pulmonary sarcoidosis requiring oxygen therapy for chronic respiratory failure, who were extracted from >2500 sarcoidosis patients (three hospitals, 2000−2018). Patients with comorbidities causing chronic respiratory failure were excluded. Results: Predominant findings were consolidations along the bronchovascular bundles comprising ‘central-peripheral band’, traction bronchiectasis, peripheral cysts/bullae, and upper lobe shrinkage. Traction bronchiectasis arose from opacities comprising ‘central-peripheral band’. Clustering of traction bronchiectasis at the distal side formed honeycomb lung-like structures in three patients. Upper lobe shrinkage progressed in seven patients together with progression of consolidations, ‘central-peripheral band’, traction bronchiectasis clusters, and cysts, while patients without shrinkage included two patients with severe multiple cysts without traction bronchiectasis. Restrictive ventilatory impairment developed in most patients. Pulmonary hypertension (PH) was detected radiologically in five patients, and chronic progressive pulmonary aspergillosis (CPPA) in four patients. Conclusions: During progression, consolidations comprising ‘central-peripheral band’ progressed together with traction bronchiectasis clusters and peripheral cysts, resulting in upper lobe shrinkage. This may lead to respiratory failure with possible complications such as PH and CPPA. |
topic |
sarcoidosis fibrosis upper lobe shrinkage traction bronchiectasis honeycomb lung cyst consolidation chronic respiratory failure home oxygen therapy hilar mediastinal lymphadenopathy |
url |
https://www.mdpi.com/2077-0383/9/1/142 |
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