Case contributed by Dr Mark Hall


Smoker, presents with 2 month history of productive cough with no response to antibiotics.

Patient Data

Age: 30 years
Gender: Female

Chest Radiograph

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

There is extensive bilateral (<3 mm) 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 visualized 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 hilar 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
Published: 6th May 2016
Last edited: 7th Jan 2019
System: Chest
Inclusion in quiz mode: Included

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