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Pulmonary sarcoidosis - stage IV

Case contributed by Roberto Schubert
Diagnosis probable

Presentation

Severe dyspnea.

Patient Data

Age: 55 years
Gender: Female

Chest

x-ray

Confluous, bilateral, symmetric reticulonodular opacities.

Marked increase of reticular interstitial pattern particular affecting the perihilar areas, suggestive of advanced fibrosis. 

Upper mediastinal and bilateral hilar enlargement likely representing lymphadenopathy. 

Chest

ct

Irregular, coarse, bilateral nodular thickening showing a primarily perilymphatic distribution. 

Confluent predominantly perihilar ground-glass opacities. 

Thickened interstitial septae indicating fibrosis. 

Hilar and mediastinal lymphadenopathy (not well demonstrated by the lung window slice).

Case Discussion

Findings are in line with advanced (stage IV) pulmonary sarcoidosis

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