[Signs of inflammatory activity in thoracic sarcoidosis. A high-resolution computerized tomography study]

Sarcoidosis is characterized by the presence of non-caseating granulomas. Lymphadenopathy and diffuse parenchymal abnormalities often involve the chest. This study was aimed at finding out signs that could be suggestive of disease activity and if the lesions are reversible after therapy. Sixty-three patients underwent chest radiography, high resolution CT, functional studies, bronchoalveolar lavage and 67Ga scintigraphy. Twenty-three patients were followed-up. Lymphadenopathies, nodular opacities and acinar opacities resolved after steroid therapy; bronchiolectasies, bronchiectasies, septal thickening and parenchymal distorsion did not disappeared after therapy and are therefore considered as irreversible lesions. Ground glass opacities are an uncommon finding; they are due to fibrosis or to widespread interstitial granulomas rather than alveolitis. The prognostic meaning of ground glass opacities is uncertain. Therefore, disease activity findings are mainly lymphadenopathies, nodules and consolidations. Nevertheless these findings not necessarily imply a bad prognosis, as acute sarcoidosis seems to respond well to steroid therapy, even with complete remission. It remains debated if a CT study is worthwhile in all the new cases of sarcoidosis or only in the clinically more severe ones.