Sarcoidosis is a systemic inflammatory disease of idiopathic etiology affecting the lungs, eyes, skin, heart, and liver, though the extent of extra thoracic involvement varies between patients.40 Up to 20% of patients with sarcoidosis develop pulmonary fibrosis, termed fibrotic sarcoidosis.40 The predominant findings are granulomas surrounded by fibroblastic foci, accompanied by a variable degree of volume loss, architectural distortion, bronchial distortion, and honeycombing. Traction bronchiectasis is often observed, and fibrosis is predominantly limited to the upper and middle lobes.40

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Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline

Reference

40. Patterson KC, Strek ME. Pulmonary fibrosis in sarcoidosis. Clinical features and outcomes. Ann Am Thorac Soc. 2013;10:362-370.