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Sarcoidosis - end stage

Case contributed by: Dr Frank Gaillard
Modality: X-ray

Extensive bilateral interstitial opacities are present which have a reticulonodular pattern. 

Modality: CT

Extensive perilymphatic nodularity is unchanged, and is suggestive of active sarcoidosis. Paraseptal emphysema and peripheral honeycombing are again seen (stage IV). As before, multiple calcified granulomata are present bilaterally.

Calcified left hilar nodes are unchanged. The prevascular nodes have decreased slightly in size.

The main pulmonary artery is again dilated at 3.1 cm, in keeping with pulmonary arterial hypertension. The small pericardial effusion persists. The small bilateral pleural effusions have resolved.

Impression

  1. Findings in keeping with sarcoidosis with both pulmonary and nodal involvement. Persistent perilymphatic nodularity is suggestive of continued activity.
  2. Pulmonary arterial hypertension, and persistent small pericardial effusion.

Case Discussion:

This patient has known established long-standing sarcoidosis

 

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