Pulmonary sarcoidosis in childhood.

Clinical and radiologic characteristics of pulmonary sarcoidosis in 26 children are presented. Initial nonspecific symptomatology and decreased pulmonary function are almost invariably accompanied by radiologic evidence of pulmonary disease. Bilateral hilar lymphadenopathy frequently associated with bilateral paratracheal adenopathy is characteristic. Other mediastinal lymphadenopathy (subcarinal, anterior, and posterior) is sporadically present, and is invariably associated with the more specific bilateral patterns of thoracic adenopathy. Pulmonary parenchymal involvement is common and predominantly appears radiographically as small irregular densities. Pleural effusion, pneumothorax, and cardiomegaly are unusual findings. Extrathoracic radiographic manifestations are uncommon. Lytic lesions of the tubular bones of the hands and feet are rare in childhood.