The Prognosis of Sarcoidosis

The disease can remit spontaneously or become chronic, with exacerbations and remissions. In some persons, it can progress to pulmonary fibrosis and death. About half of cases resolve without treatment or can be cured within 12–36 months, and most within five years. Some cases, however, may persist several decades.^[6] Two-thirds of people with the condition achieve a remission within 10 years of the diagnosis.^[103] When the heart is involved, the prognosis is generally less favourable, although, corticosteroids appear effective in improving AV conduction.^[104][105] The prognosis tends to be less favourable in African Americans, compared to white Americans.^[4] Persons with sarcoidosis appear to be at significantly increased risk for cancer, in particular lung cancer, lymphomas,^[106] and cancer in other organs known to be affected in sarcoidosis.^[107][108] In sarcoidosis-lymphoma syndrome, sarcoidosis is followed by the development of a lymphoproliferative disorder such as non-Hodgkin lymphoma.^[109] This may be attributed to the underlying immunological abnormalities that occur during the sarcoidosis disease process.^[110] Sarcoidosis can also follow cancer^[111] or occur concurrently with cancer.^[112][113] There have been reports of hairy cell leukemia,^[114] acute myeloid leukemia,^[115] and acute myeloblastic leukemia^[116] associated with sarcoidosis.
Gross pathology image showing sarcoidosis with honeycombing: Prominent honeycombing is present in the lower lobes accompanied by fibrosis and some honeycombing in the upper lungs. Honeycombing consists of cystically dilated airways separated by scar tissue resembling the honeycomb of bees. It is a nonspecific end stage of many types of interstitial lung disease.