Pulmonary sarcoidosis

Case contributed by Dr Bruno Di Muzio

Presentation

Cough for three months.

Patient Data

Age: 35 years
Gender: Female
X-ray

Chest Radiograph

There is a widespread reticular nodular pattern involving both lungs with no areas of consolidation. Apart from pleural scarring in both apices, the pleural spaces are clear. The right paratracheal stripe is demonstrated enlarged and there is a possible right hilar prominent lymph node. There is no pneumothorax or subphrenic free gas. No suspicious bone lesions.

CT

CT Chest

Multiple enlarged mediastinal and hilar lymph nodes are identified, many containing stippled calcification. No enlarged axillary lymph nodes or upper retroperitoneal nodes are identified. Several scattered tiny pulmonary micronodules are identified, some densely calcified. Most are less than 2 mm, while the largest is a 5 mm nodule in the anterior segments of the right upper lobe, immediately adjacent to a vascular branch. There is a beaded appearance to the left oblique fissure and to a lesser extent of the right-sided fissures. Possible subtle interlobular septal thickening is demonstrated in the mid zones. Changes in the lung bases are due to dependent atelectasis. No pleural effusion. Allowing for arterial phase enhancement, the imaged upper abdominal viscera are within normal limits. 

Case Discussion

This case has imaging appearances very characteristic of pulmonary sarcoidosis. This patient has had the diagnostic confirmed and has been followed in the respiratory clinic. 

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Case information

rID: 55807
Case created: 26th Sep 2017
Last edited: 6th Nov 2017
System: Chest
Inclusion in quiz mode: Included

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