Sarcoid Nodule or Lung Cancer? A High-Resolution Computed Tomography-Based Retrospective Study of Pulmonary Nodules in Patients with Sarcoidosis
Chiara Catelli,
Susanna Guerrini,
Miriana D’Alessandro,
Paolo Cameli,
Antonio Fabiano,
Giorgio Torrigiani,
Cristiana Bellan,
Maria Antonietta Mazzei,
Piero Paladini,
Luca Luzzi
Affiliations
Chiara Catelli
Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Susanna Guerrini
Diagnostic Imaging Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Miriana D’Alessandro
Respiratory Disease and Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Siena University, 53100 Siena, Italy
Paolo Cameli
Respiratory Disease and Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Siena University, 53100 Siena, Italy
Antonio Fabiano
Thoracic Surgery Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Giorgio Torrigiani
Diagnostic Imaging Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Cristiana Bellan
Institute of Pathological Anatomy and Histology, Department of Medical Biotechnologies, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Maria Antonietta Mazzei
Diagnostic Imaging Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Piero Paladini
Thoracic Surgery Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Luca Luzzi
Lung Transplant Unit, Department of Medical, Surgical and Neuro-Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Background: The objective of this retrospective study was to compare the characteristics of sarcoid nodules and neoplastic nodules using high-resolution computed tomography (HRCT) in sarcoidosis patients. Methods: This is a single-center retrospective study. From 2010 to 2023, among 685 patients affected by pulmonary sarcoidosis, 23 patients developed pulmonary nodules of a suspicious malignant nature. The HRCT characteristics of biopsy-proven malignant (Group A) vs. inflammatory (Group B) nodules were analyzed and compared. Results: A significant difference was observed between the groups in terms of age (p = 0.012). With regard to HRCT features, statistical distinctions were observed in the appearance of the nodule, more frequently spiculated in the case of lung cancer (p p p p = 0.043). In Group A, the 18-PET-CT demonstrated hilar/mediastinal lymphadenopathy in 100% of cases; histology following surgery did not report any cases of malignant lymph node involvement. Conclusions: An accurate clinical evaluation and HRCT investigation are crucial for diagnosing lung cancer in patients with sarcoidosis in order to determine who requires surgical resection. The spiculated morphology of the nodule, greater size, the number of pulmonary nodules, and density using HRCT appear to correlate with the malignant nature of the lesion.
