Pulmonary sarcoidosis with and without extrapulmonary involvement: a cross-sectional and observational study in China.

OBJECTIVES: Sarcoidosis is a multisystem disease characterised by the formation of granulomas within various organs, mainly the lungs. Several studies from different countries have been undertaken to investigate sarcoidosis with extrapulmonary involvement except from China. The objective of this study is to investigate a comparative clinical analysis in patients with pulmonary sarcoidosis with and without extrapulmonary involvement from China. METHODS: Data from inpatients diagnosed with sarcoidosis at Shanghai Pulmonary Hospital (Shanghai, China) between January 2009 and December 2014 were retrospectively collected and analysed. Six hundred and thirty-six patients with biopsy-proven sarcoidosis were included in the study, including 378 isolated pulmonary sarcoidosis and 258 pulmonary sarcoidosis plus extrapulmonary involvement. RESULTS: Two hundred and fifty-eight (40.6%) patients with pulmonary sarcoidosis had extrapulmonary involvement. Extrapulmonary localisations were detected mostly in extrathoracic lymph nodes (n=147) and skin (n=86). Statistically significant differences were demonstrated between patients with pulmonary sarcoidosis plus extrapulmonary involvement and patients with isolated pulmonary sarcoidosis for fatigue (16.6%vs8.3%, P<0.05), serum ACE (SACE) levels (79.0±46.9 IU/L vs 69.7±38.7 IU/L, P<0.05), and high-resolution CT (HRCT) findings (53.8%vs46.2%, P<0.05). CONCLUSIONS: Extrapulmonary involvement is common in patients with pulmonary sarcoidosis, with the most common sites being extrathoracic lymph nodes and skin. Patients with sarcoidosis with extrapulmonary involvement are more symptomatic (fatigue), have higher SACE levels and more deteriorating HRCT findings, to which clinicians should pay attention.

[Imaging diagnosis of pelvic eosinophilic granuloma and analyses of the misdiagnoses].

OBJECTIVE: To explore the imaging diagnosis of pelvic eosinophilic granuloma and improve diagnosis accuracy. METHODS: A retrospective analysis of the plain film, CT and MRI was conducted in 24 cases of pathologically confirmed eosinophilic granuloma. All the patients received radiography, CT scan was performed in 17 cases and MRI was done 9 cases. RESULTS: In the 24 cases of eosinophilic granuloma, 6 lesions were located in the pubis, 5 in the ischium and 13 in the iliac region. The lesion showed bony destruction or irregular bony destruction, with periosteal reaction and soft tissue mass. CONCLUSION: Pelvic eosinophilic granuloma has characteristic imaging features, and combination of the imaging findings can improve the diagnosing accuracy.