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The authors have staged by CT 57 cases of sarcoidosis. In all cases CT has given superior semiologic pattern in comparison with plain-films which are the classical baseline references (Turiaf)...up to date. 30% of type I sarcoidosis are staged as type II by thin-section CT slices. This radio-clinic evaluation must be continued on months to find if this group is an homogeneous one in the prognostic meaning and if cortico-therapy is useful. The authors propose a systematic CT evaluation of sarcoidosis in 1987 and a CT actualization of the radiologic classification of the disease.

Among 400 patients with sarcoidosis in Moscow 8.5% (34) were found among children and adolescents. Predominance of females, observed among adults could not be found in children and adolescents (27 males, 7 females). Most cases were stadium I (21); stad. II 11, stad. III 2. In patients with stadium I and II extrapulmonary lesions were rather frequent (1/3 of all cases). Clinical picture, X-ray findings and symptoms are discussed. Tuberculin reaction was negative in 29 of 34 patients.

In Czechoslovakia the yearly incidence of sarcoidosis has been followed-up from the year 1971 on the whole territory, in each of 112 districts separately. All together it makes no difference what diagnostic procedure has corroborated the diagnosis or whether the patient at the time when sarcoidosis was ascertained did or did not have any disturbances. The number relative to 100000 inhavitants of each district varied greatly up to the end of 1975, from 0 to 32 per 100000 people. In 10 districts it was higher than 6:100000. As the very districts with the highest incidence in 7 out of 10 districts adjoined the districts with the zero incidence it seems to be logical to resume that the zero incidence in none of the 21 districts was a real one. The sex and age distribution, the number of persons with histologically verified diagnosis, the intrathoracic and extrathoracic localisation of sarcoidosis and the distribution of the stages of intrathoracic sarcoidosis have been followed-up in 1442, respectively in 1839 patients observed in the last five years period. The necessity of a new prospective cooporative controlled study of the incidence of sarcoidosis in some European countries seems to be evident.

The historical background to the disorder is unfolded. It was originally regarded as a dermatological curiosity, and later sarcoidosis was recognized as a disorder diffusely involving most tissues of the body. Clinical syndromes described include those presenting to the dermatologist, ophthalmologist, chest physician and radiologist, gastroenterologist and neurologist. Tissues commonly involved are lungs, lymph nodes, eyes, skin and bone in that order of frequency. Granulomatous uveitis in the presence of skin lesions should always arouse the suspicion of sarcoidosis; ocular and bone involvement are frequently associated with lupus pernio, whereas lymphadenopathy and splenomegaly are more commonly linked with plaques and maculo-papular eruptions. Bone cysts are rare in the absence of skin lesions, so routine radiography of hands and feet is of little diagnostic value. The basic criteria for establishing the diagnosis of sarcoidosis are twofold: (a) Suggestive clinical and/or radiological features with evidence of generalized involvement. (b) Histological proof of sarcoid tissue from at least one tissue. Evidence of one without the other is insufficient, for clinical or radiological manifestations alone present too wide a differential diagnostic problem and, conversely, isolated histological evidence of sarcoid tissue could be construed as a local sarcoid-tissue reaction. Histological confirmation is obtained whenever possible from accessible involved tissues (skin or lymph node). Otherwise blind biopsy of liver, scalene lymph node or gastrocnemius muscle is employed, or alternatively the Siltzbach-Kveim test is performed. It is a safe, simple and specific outpatient skin test, which provides histological confirmation in three-quarters of patients with sarcoidosis. The natural history of sarcoidosis and the response to treatment vary with the type of disease--namely subacute (transient) or chronic (persistent) forms of sarcoidosis. The only treatment which favourably influences clinical, or radiological or histological features of the disease is corticosteroid therapy. Indications for treatment are: ophthalmic involvement, steadily worsening chest radiograph, breathlessness, persistent hypercalciuria, disfiguring skin lesions, neurological involvement, disordered glandular function.