Literature DB >> 24551020

The reversed halo sign extending the spectrum of atypical radiological manifestations in sarcoidosis.

Edson Marchiori1, Gláucia Zanetti1, Marcos Duarte Guimarães2, Bruno Hochhegger1.   

Abstract

Entities:  

Year:  2014        PMID: 24551020      PMCID: PMC3912689          DOI: 10.4103/1817-1737.124445

Source DB:  PubMed          Journal:  Ann Thorac Med        ISSN: 1998-3557            Impact factor:   2.219


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Sir, We read with great interest the well-written pictorical essay by Al-Jahdali et al.,[1] which reviews the wide spectrum of atypical thoracic manifestations of sarcoidosis on imaging methods, emphasizing the importance of understanding the radiological manifestations in making a proper diagnosis. In order to contribute to this excellent review, we would like to include another atypical tomographic aspect of sarcoidosis, which is the reversed halo sign (RHS). RHS is defined as a focal, round area of ground-glass attenuation surrounded by a partial or complete rim of consolidation. This sign was initially described as a relatively specific of cryptogenic organizing pneumonia. However, subsequent publications identified this sign in a wide spectrum of diseases, including infectious and non-infectious conditions, among them pulmonary sarcoid is included.[23] Although the RHS must be regarded as a non-specific sign that is encountered in various pulmonary diseases, in cases of sarcoidosis the sign has distinctive morphological characteristics. In patients with sarcoidosis, the ring or the inner area of the reversed halo is nodular in appearance. Furthermore, small nodules within the central ground-glass region of the RHS were seen. Histopathologic analysis of such specimens has revealed the presence of granulomas within the ring portion of the RHS and/or inside the RHS.[45] The same aspect was seen in active granulomatous infectious diseases, particularly tuberculosis.[5] In conclusion, the RHS with nodular pattern should be included in the spectrum of parenchymal abnormalities that are observed on high resolution computed tomography in patients with sarcoidosis.
  5 in total

1.  Reversed halo sign: high-resolution CT scan findings in 79 patients.

Authors:  Edson Marchiori; Gláucia Zanetti; Dante Luiz Escuissato; Arthur Soares Souza; Gustavo de Souza Portes Meirelles; Joana Fagundes; Carolina Althoff Souza; Bruno Hochhegger; Edith M Marom; Myrna C B Godoy
Journal:  Chest       Date:  2011-10-20       Impact factor: 9.410

2.  Re: Reversed halo sign: nodular wall as criterion for differentiation between cryptogenic organizing pneumonia and active granulomatous diseases.

Authors:  E Marchiori; G Zanetti; B Hochhegger; K L Irion
Journal:  Clin Radiol       Date:  2010-05-01       Impact factor: 2.350

3.  The reversed halo sign on high-resolution CT in infectious and noninfectious pulmonary diseases.

Authors:  Edson Marchiori; Gláucia Zanetti; Gustavo Souza Portes Meirelles; Dante L Escuissato; Arthur Soares Souza; Bruno Hochhegger
Journal:  AJR Am J Roentgenol       Date:  2011-07       Impact factor: 3.959

4.  The reversed halo sign: another atypical manifestation of sarcoidosis.

Authors:  Edson Marchiori; Gláucia Zanetti; Cláudia Mauro Mano; Bruno Hochhegger; Klaus Loureiro Irion
Journal:  Korean J Radiol       Date:  2010-02-22       Impact factor: 3.500

Review 5.  Atypical radiological manifestations of thoracic sarcoidosis: A review and pictorial essay.

Authors:  Hamdan Al-Jahdali; Prabhakar Rajiah; Shyam Sunder Koteyar; Carolyn Allen; Ali Nawaz Khan
Journal:  Ann Thorac Med       Date:  2013-10       Impact factor: 2.219

  5 in total
  1 in total

Review 1.  The Clinical Features of Sarcoidosis: A Comprehensive Review.

Authors:  Marc A Judson
Journal:  Clin Rev Allergy Immunol       Date:  2015-08       Impact factor: 8.667

  1 in total

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