Sarcoidosis: Clinical and Thoracic Roentgen Features

¹ The Department of Medicine, B. S. Pollak Hospital for Chest Diseases., Director of Medicine and Professor of Medicine, Seton Hall College of Medicine and Dentistry.
² The Department of Medicine, B. S. Pollak Hospital for Chest Diseases., Assistant Attending Physician and Senior Instructor in Clinical Medicine, Seton Hall College of Medicine and Dentistry.
³ The Department of Medicine, B. S. Pollak Hospital for Chest Diseases.

In a review of clinical material, 45 cases have been accepted for inclusion in a study of sarcoidosis. Twenty (44 per cent) had histologic confirmation and in the remainder, prolonged observation on the basis of clinical, roentgenological and laboratory findings made the diagnosis tenable. Forty (89 per cent) are living and all but three are working or able to work. Sixty per cent of the living cases have been followed for at least five years, the longest 18 years. Five (11 per cent) died and their length of survival ranged from two to nine years. The causes of death were: (a) chronic cor pulmonale and right heart failure (40 per cent); (b) tuberculosis (40 per cent) (C) cause unknown (20 per cent).

Comparing the first and last x-ray film of each patient, it was observed that: (a) regression occurred in 56 per cent; (b) no significant change in 40 per cent; (c) progression with development of super-imposed tuberculosis (positive sputum) occurred in 4 per cent.

Prognosis is good for the majority of patients with sarcoidosis. The rate of spontaneous regression of thoracic lesions is favorable. There is no specific treatment, but steroids may exert a suppressive effect in some instances. Eight patients (18 per cent) in this series received steroids. All but two showed improvement during therapy and one had a symptomatic relapse after its cessation.