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Sarcoid
Wendie A. Berg, MD, PhD, FACR, FSBI; Wei Tse Yang, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Sarcoidosis, Boeck disease, Hutchinson disease
            • Definitions

              • Chronic inflammatory disease
              • Systemic granulomatous disorder of unknown etiology
                • Initially described in 1877 by Hutchinson, an English physician
                • Boeck described cutaneous lesions and histopathology as "sarcoid" because lesions resembled sarcoma (sarc-) but were benign (-oid)
                • Diagnosis established when clinical and radiological findings supported by histopathology showing noncaseating epithelioid granulomas

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • CT Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Illman JE et al: Granulomatous diseases of the breast and axilla: radiological findings with pathological correlation. Insights Imaging. 9(1):59-71, 2018
                                            2. James WE et al: Treatment of sarcoidosis: grading the evidence. Expert Rev Clin Pharmacol. 11(7):677-687, 2018
                                            3. Arish N et al: Characteristics of sarcoidosis in patients with previous malignancy: Causality or coincidence? Respiration. 93(4):247-252, 2017
                                            4. Kim SJ et al: Clinical importance and sonographic features of nonpalpable axillary lymphadenopathy identified on breast sonography in patients without malignancy. J Ultrasound Med. 34(12):2193-202, 2015
                                            5. Blank N et al: Sarcoidosis and the occurrence of malignant diseases. Rheumatol Int. 34(10):1433-9, 2014
                                            6. Valeyre D et al: Sarcoidosis. Lancet. 383(9923):1155-67, 2014
                                            7. Isley LM et al: Primary sarcoid of the breast with incidental malignancy. J Clin Imaging Sci. 2:46, 2012
                                            8. Bush E et al: Sarcoidosis mimicking metastatic breast cancer. Breast J. 17(5):533-5, 2011
                                            9. Cao MM et al: Mammographic signs of systemic disease. Radiographics. 31(4):1085-100, 2011
                                            10. Panzacchi R et al: Primary sarcoidosis of the breast: case description and review of the literature. Pathologica. 102(3):104-7, 2010
                                            11. Hermann G et al: Unusual presentation of sarcoidosis of the breast. Br J Radiol. 81(969):e231-3, 2008
                                            12. Nguyen BD: F-18 FDG PET imaging of disseminated sarcoidosis. Clin Nucl Med. 32(1):53-4, 2007
                                            13. Nicholson BT et al: Sarcoidosis of the breast: An unusual presentation of a systemic disease. Breast J. 13(1):99-100, 2007
                                            14. Harisinghani MG et al: A pilot study of lymphotrophic nanoparticle-enhanced magnetic resonance imaging technique in early stage testicular cancer: a new method for noninvasive lymph node evaluation. Urology. 66(5):1066-71, 2005
                                            15. Mona el K et al: Quiz case. Breast sarcoidosis presenting as a metastatic breast cancer. Eur J Radiol. 54(1):2-5, 2005
                                            16. Sabaté JM et al: Radiologic evaluation of uncommon inflammatory and reactive breast disorders. Radiographics. 25(2):411-24, 2005
                                            17. Garcia CA et al: FDG-positron emission tomographic imaging in carcinoma of the breast: interference by massive sarcoidosis. Clin Nucl Med. 28(3):218-9, 2003
                                            18. Ishimaru K et al: Sarcoidosis of the breast. Eur Radiol. 12 Suppl 3:S105-8, 2002
                                            19. Lower EE et al: Breast disease in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 18(3):301-6, 2001
                                            20. Takahashi R et al: Mammary involvement in a patient with sarcoidosis. Intern Med. 40(8):769-71, 2001
                                            21. Gisvold JJ et al: Sarcoidosis presenting as spiculated breast masses. Mayo Clin Proc. 75(3):293-5, 2000
                                            22. Ojeda H et al: Sarcoidosis of the breast: implications for the general surgeon. Am Surg. 66(12):1144-8, 2000
                                            23. Kirshy D et al: Sarcoidosis of the breast presenting as a spiculated lesion. AJR Am J Roentgenol. 172(2):554-5, 1999
                                            24. Statement on sarcoidosis: Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 160(2):736-55, 1999
                                            25. Yamada Y et al: Fluorine-18-fluorodeoxyglucose and carbon-11-methionine evaluation of lymphadenopathy in sarcoidosis. J Nucl Med. 39(7):1160-6, 1998
                                            26. Kenzel PP et al: Boeck sarcoidosis of the breast: mammographic, ultrasound, and MR findings. J Comput Assist Tomogr. 21(3):439-41, 1997
                                            27. Bergkvist L et al: Management of accidentally found pathological lymph nodes on routine screening mammography. Eur J Surg Oncol. 22(3):250-3, 1996
                                            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

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Sarcoidosis, Boeck disease, Hutchinson disease
                                                      • Definitions

                                                        • Chronic inflammatory disease
                                                        • Systemic granulomatous disorder of unknown etiology
                                                          • Initially described in 1877 by Hutchinson, an English physician
                                                          • Boeck described cutaneous lesions and histopathology as "sarcoid" because lesions resembled sarcoma (sarc-) but were benign (-oid)
                                                          • Diagnosis established when clinical and radiological findings supported by histopathology showing noncaseating epithelioid granulomas

                                                      IMAGING

                                                      • General Features

                                                        • Mammographic Findings

                                                          • Ultrasonographic Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • CT Findings

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Illman JE et al: Granulomatous diseases of the breast and axilla: radiological findings with pathological correlation. Insights Imaging. 9(1):59-71, 2018
                                                                                      2. James WE et al: Treatment of sarcoidosis: grading the evidence. Expert Rev Clin Pharmacol. 11(7):677-687, 2018
                                                                                      3. Arish N et al: Characteristics of sarcoidosis in patients with previous malignancy: Causality or coincidence? Respiration. 93(4):247-252, 2017
                                                                                      4. Kim SJ et al: Clinical importance and sonographic features of nonpalpable axillary lymphadenopathy identified on breast sonography in patients without malignancy. J Ultrasound Med. 34(12):2193-202, 2015
                                                                                      5. Blank N et al: Sarcoidosis and the occurrence of malignant diseases. Rheumatol Int. 34(10):1433-9, 2014
                                                                                      6. Valeyre D et al: Sarcoidosis. Lancet. 383(9923):1155-67, 2014
                                                                                      7. Isley LM et al: Primary sarcoid of the breast with incidental malignancy. J Clin Imaging Sci. 2:46, 2012
                                                                                      8. Bush E et al: Sarcoidosis mimicking metastatic breast cancer. Breast J. 17(5):533-5, 2011
                                                                                      9. Cao MM et al: Mammographic signs of systemic disease. Radiographics. 31(4):1085-100, 2011
                                                                                      10. Panzacchi R et al: Primary sarcoidosis of the breast: case description and review of the literature. Pathologica. 102(3):104-7, 2010
                                                                                      11. Hermann G et al: Unusual presentation of sarcoidosis of the breast. Br J Radiol. 81(969):e231-3, 2008
                                                                                      12. Nguyen BD: F-18 FDG PET imaging of disseminated sarcoidosis. Clin Nucl Med. 32(1):53-4, 2007
                                                                                      13. Nicholson BT et al: Sarcoidosis of the breast: An unusual presentation of a systemic disease. Breast J. 13(1):99-100, 2007
                                                                                      14. Harisinghani MG et al: A pilot study of lymphotrophic nanoparticle-enhanced magnetic resonance imaging technique in early stage testicular cancer: a new method for noninvasive lymph node evaluation. Urology. 66(5):1066-71, 2005
                                                                                      15. Mona el K et al: Quiz case. Breast sarcoidosis presenting as a metastatic breast cancer. Eur J Radiol. 54(1):2-5, 2005
                                                                                      16. Sabaté JM et al: Radiologic evaluation of uncommon inflammatory and reactive breast disorders. Radiographics. 25(2):411-24, 2005
                                                                                      17. Garcia CA et al: FDG-positron emission tomographic imaging in carcinoma of the breast: interference by massive sarcoidosis. Clin Nucl Med. 28(3):218-9, 2003
                                                                                      18. Ishimaru K et al: Sarcoidosis of the breast. Eur Radiol. 12 Suppl 3:S105-8, 2002
                                                                                      19. Lower EE et al: Breast disease in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 18(3):301-6, 2001
                                                                                      20. Takahashi R et al: Mammary involvement in a patient with sarcoidosis. Intern Med. 40(8):769-71, 2001
                                                                                      21. Gisvold JJ et al: Sarcoidosis presenting as spiculated breast masses. Mayo Clin Proc. 75(3):293-5, 2000
                                                                                      22. Ojeda H et al: Sarcoidosis of the breast: implications for the general surgeon. Am Surg. 66(12):1144-8, 2000
                                                                                      23. Kirshy D et al: Sarcoidosis of the breast presenting as a spiculated lesion. AJR Am J Roentgenol. 172(2):554-5, 1999
                                                                                      24. Statement on sarcoidosis: Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 160(2):736-55, 1999
                                                                                      25. Yamada Y et al: Fluorine-18-fluorodeoxyglucose and carbon-11-methionine evaluation of lymphadenopathy in sarcoidosis. J Nucl Med. 39(7):1160-6, 1998
                                                                                      26. Kenzel PP et al: Boeck sarcoidosis of the breast: mammographic, ultrasound, and MR findings. J Comput Assist Tomogr. 21(3):439-41, 1997
                                                                                      27. Bergkvist L et al: Management of accidentally found pathological lymph nodes on routine screening mammography. Eur J Surg Oncol. 22(3):250-3, 1996