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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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Autores principales: Sawahata, Michiru, Johkoh, Takeshi, Kawanobe, Takeshi, Kono, Chiyoko, Nakamura, Yosikazu, Bando, Masashi, Hagiwara, Koichi, Takemura, Tamiko, Sakai, Fumikazu, Shijubo, Noriharu, Konno, Satoshi, Yamaguchi, Tetsuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019246/
https://www.ncbi.nlm.nih.gov/pubmed/31948067
http://dx.doi.org/10.3390/jcm9010142
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author Sawahata, Michiru
Johkoh, Takeshi
Kawanobe, Takeshi
Kono, Chiyoko
Nakamura, Yosikazu
Bando, Masashi
Hagiwara, Koichi
Takemura, Tamiko
Sakai, Fumikazu
Shijubo, Noriharu
Konno, Satoshi
Yamaguchi, Tetsuo
author_facet Sawahata, Michiru
Johkoh, Takeshi
Kawanobe, Takeshi
Kono, Chiyoko
Nakamura, Yosikazu
Bando, Masashi
Hagiwara, Koichi
Takemura, Tamiko
Sakai, Fumikazu
Shijubo, Noriharu
Konno, Satoshi
Yamaguchi, Tetsuo
author_sort Sawahata, Michiru
collection PubMed
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.
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spelling pubmed-70192462020-03-04 Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure Sawahata, Michiru Johkoh, Takeshi Kawanobe, Takeshi Kono, Chiyoko Nakamura, Yosikazu Bando, Masashi Hagiwara, Koichi Takemura, Tamiko Sakai, Fumikazu Shijubo, Noriharu Konno, Satoshi Yamaguchi, Tetsuo J Clin Med Article 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. MDPI 2020-01-05 /pmc/articles/PMC7019246/ /pubmed/31948067 http://dx.doi.org/10.3390/jcm9010142 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sawahata, Michiru
Johkoh, Takeshi
Kawanobe, Takeshi
Kono, Chiyoko
Nakamura, Yosikazu
Bando, Masashi
Hagiwara, Koichi
Takemura, Tamiko
Sakai, Fumikazu
Shijubo, Noriharu
Konno, Satoshi
Yamaguchi, Tetsuo
Computed Tomography Images of Fibrotic Pulmonary Sarcoidosis Leading to Chronic Respiratory Failure
title 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_short 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019246/
https://www.ncbi.nlm.nih.gov/pubmed/31948067
http://dx.doi.org/10.3390/jcm9010142
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