Spectrum of Interstitial Lung Disease in Sarcoidosis

Sarcoidosis is a multifactorial granulomatous disease that affects adults of all ages, primarily targeting the lungs. Symptoms can range from none at all to severe respiratory failure requiring lung transplantation. Diagnosis is made using three main criteria: compatible clinical or radiological findings, histological proof of non-necrotizing granulomatous inflammation in tissue, and ruling out other causes of granulomatous disease. Pulmonary fibrosis, advanced findings on high-resolution chest CT, decreased pulmonary function, and pulmonary hypertension are widely recognized as significant predictors of adverse clinical outcomes. A narrative, non-systematic review of important recent literature was carried out using computerized database searches, manual searches, and authoritative sources. This review examines the various patterns observed in high-resolution computerized tomography of the chest and their association with the severity and the pathophysiology of sarcoidosis. The patterns addressed include nodules, ground-glass opacities, consolidations, honeycombing, traction bronchiectasis, and cysts. Both historical and current methods of categorizing high-resolution CT interstitial findings will be reviewed.

· Chest HRCT in sarcoidosis demonstrates a broad spectrum of interstitial lung disease patterns, including micronodules, ground-glass opacities, traction bronchiectasis, honeycombing, and cystic change, with important implications for differential diagnosis.. · The diagnosis of pulmonary sarcoidosis requires concordant clinical and radiologic findings, histologic evidence of non-necrotizing granulomatous inflammation, and exclusion of alternative granulomatous disorders.. · Fibrotic HRCT manifestations of sarcoidosis are associated with adverse clinical outcomes, including impaired pulmonary function, pulmonary hypertension, and chronic respiratory failure, and should be distinguished from UIP/IPF despite overlapping imaging features..

· Al-Qaqaa R, Lazarus MS, Franco A. Spectrum of Interstitial Lung Disease in Sarcoidosis. Rofo 2026; DOI 10.1055/a-2871-9924.