Sarcoidosis

Case contributed by Dr Mark Hall

Presentation

A 29 year old female, smoker, presents via their General Practitioner with 2 month history of productive cough with no response to antibiotics.

Patient Data

Age: 29
Gender: Female

Chest Radiograph

Modality: X-ray

There is a widespread, predominantly reticulonodular pattern with relative sparing of the lung bases.  There is widening of the right paratracheal stripe and a bulky left hilum in keeping with underlying lymphadenopathy.

Non contrast CT Chest

Modality: CT

There is extensive bilateral (<3mm) nodular pulmonary infiltrate with nodularity also present in relation to the fissures.  In addition there is bilateral hilar and paratracheal lymphadenopathy.  The subpleural region is involved and there is relative sparing of the bases.  

Within the upper abdomen, the whole of the spleen is not completely visualised but measures at least 13 cm, suggesting splenomegaly.  Renal cyst and calculi.  

Case Discussion

Whilst there is a broad differential of nodular pulmonary infiltrates the combination of bilateral lymphadenopathy and peri-fissural nodules makes sarcoidosis the most likely diagnosis.  

The patient went on to have a transbronchial lung biopsy which confirmed the diagnosis.

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Case Information

rID: 44870
Case created: 6th May 2016
Last edited: 1st Feb 2017
System: Chest
Inclusion in quiz mode: Included

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