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Necrotizing Sarcoid Granulomatosis
Aletta Ann Frazier, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Necrotizing sarcoid granulomatosis (NSG): Noncaseating granulomatous disease + lung necrosis and vasculitis
                • Rare and controversial entity; possible variant or later stage of nodular sarcoidosis
                • Legacy term: "cavitary sarcoidosis"

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Makimoto G et al: Successful corticosteroid treatment of necrotizing sarcoid granulomatosis associated with tracheal lesion recurred after a surgical lung biopsy. Respir Med Case Rep. 33:101402, 2021
                                            2. Crouser ED et al: Diagnosis and detection of sarcoidosis. an Official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 201(8):e26-51, 2020
                                            3. Naeem M et al: Noninfectious granulomatous diseases of the chest. Radiographics. 40(4):1003-19, 2020
                                            4. Parejo-Morón AI et al: Necrotizing sarcoid granulomatosis: a disease not to be forgotten. Case Rep Med. 2020:5730704, 2020
                                            5. Doubková M et al: Necrotising sarcoid granulomatosis. a rare granulomatous disease. Sarcoidosis Vasc Diffuse Lung Dis. 35(4):395-8, 2018
                                            6. Ma Y et al: Reprint of: The pathology of pulmonary sarcoidosis: update. Semin Diagn Pathol. 35(5):324-33, 2018
                                            7. Hasleton P et al: Sarcoidosis. In Spencer's Pathology of the Lung. 6th ed. Cambridge University Press. 494-5, 2013
                                            8. Arfi J et al: F-18 FDG PET/CT findings in pulmonary necrotizing sarcoid granulomatosis. Clin Nucl Med. 35(9):697-700, 2010
                                            9. Frazier AA et al: Pulmonary angiitis and granulomatosis: radiologic-pathologic correlation. Radiographics. 18(3):687-710; quiz 727, 1998
                                            10. Niimi H et al: Necrotizing sarcoid granulomatosis: computed tomography and pathologic findings. J Comput Assist Tomogr. 19(6):920-3, 1995
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Necrotizing sarcoid granulomatosis (NSG): Noncaseating granulomatous disease + lung necrosis and vasculitis
                                                          • Rare and controversial entity; possible variant or later stage of nodular sarcoidosis
                                                          • Legacy term: "cavitary sarcoidosis"

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Makimoto G et al: Successful corticosteroid treatment of necrotizing sarcoid granulomatosis associated with tracheal lesion recurred after a surgical lung biopsy. Respir Med Case Rep. 33:101402, 2021
                                                                                      2. Crouser ED et al: Diagnosis and detection of sarcoidosis. an Official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 201(8):e26-51, 2020
                                                                                      3. Naeem M et al: Noninfectious granulomatous diseases of the chest. Radiographics. 40(4):1003-19, 2020
                                                                                      4. Parejo-Morón AI et al: Necrotizing sarcoid granulomatosis: a disease not to be forgotten. Case Rep Med. 2020:5730704, 2020
                                                                                      5. Doubková M et al: Necrotising sarcoid granulomatosis. a rare granulomatous disease. Sarcoidosis Vasc Diffuse Lung Dis. 35(4):395-8, 2018
                                                                                      6. Ma Y et al: Reprint of: The pathology of pulmonary sarcoidosis: update. Semin Diagn Pathol. 35(5):324-33, 2018
                                                                                      7. Hasleton P et al: Sarcoidosis. In Spencer's Pathology of the Lung. 6th ed. Cambridge University Press. 494-5, 2013
                                                                                      8. Arfi J et al: F-18 FDG PET/CT findings in pulmonary necrotizing sarcoid granulomatosis. Clin Nucl Med. 35(9):697-700, 2010
                                                                                      9. Frazier AA et al: Pulmonary angiitis and granulomatosis: radiologic-pathologic correlation. Radiographics. 18(3):687-710; quiz 727, 1998
                                                                                      10. Niimi H et al: Necrotizing sarcoid granulomatosis: computed tomography and pathologic findings. J Comput Assist Tomogr. 19(6):920-3, 1995