I have sarcoidosis with neurological pain and inflammatory symptoms. Please interpret my scan report.

Question

Hello doctor,

I am in an awful condition and have been diagnosed with sarcoidosis. I have a range of neurological pain and inflammatory symptoms. I need someone to assess a couple of scans that I have.

I have had nasal congestion for five years, with lots of mucus in the chest and throat. Last two years, I have had some neurological symptoms like tooth pain, head pain, extreme dizziness, abnormal bodily movements, shaking in the head and tremors, extreme ringing sound in the head, vertigo, sight problems, sensitivity to light, muscle loss, neck pain, tingling, balance problems, urinary retention at times, foamy urine. I also have an unstable pulse, both in the higher and lower resting pulse ranges.

My ACE values are in the higher range. I know I have sarcoidosis. This is a diagnosis given to me by a couple of doctors. I want to know my prognosis. I suspect pulmonary fibrosis. That has also been mentioned in one report. I kindly ask you to provide me with as detailed an assessment as possible, including all abnormalities in the tissue, lymph nodes, parenchyma, numbers, and location and sizes of the nodules.

Which of them are calcified? And the condition of the blood vessels, whether they might be calcified or have other conditions concerning them.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

By the clinical images you sent (attachment removed to protect patient identity), I can understand the degree of the inflammatory response in your body tissues and concerns associated with it.

I am unable to access your radiology images and would request you to reload them.

If you are on any medications, and if not, I would recommend consulting a rheumatologist at the earliest, please, as timely treatment can reverse the damage and prevent irreparable tissue changes, especially in the lungs (fibrosis).

I am waiting for your prompt response.

I hope this helps.

Please revert in case of further queries.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Thank you for uploading the images (attachment removed to protect patient identity).

The chest images show mediastinal lymph nodes due to known sarcoidosis, but no other acute features.

The MRI (magnetic resonance imaging) of the brain shows a few lacunar infarcts in the gangliocapsular region. No diffuse parenchyma change or major finding. No large infarcts or bleed. No mass lesions. No hydrocephalus.

I would still emphasize the need to consult a rheumatologist who is better equipped to manage sarcoidosis with multisystem involvement and can control disease progression.

In terms of imaging, if you have any further questions, please feel free to discuss.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

I will explain each point in detail.

Infarcts: Systemic vasculitides lead to small vessel infarcts and are extremely rare to cause larger infarcts or any large territory involvement, as they only affect small vessels. Also, there are often new vessels to supply collaterals due to a slow and long-standing process rather than an acute phenomenon.

Lungs: The soft density lung nodules are only a few mm, with the largest up to 4 mm. The calcified ones are generally stable, but soft density needs follow-up. These nodules represent granulomas, which are a feature of sarcoidosis.

Thyroid: The thyroid nodule is cystic and in keeping with a colloid cyst. If there is any interval change in size, an ultrasound imaging can be planned, and depending on the results, further investigation, like FNA (fine needle aspiration), can be done.

I hope this helps.

Please revert in case of further queries.

Thank you.