Case contributed by Bruno Di Muzio
Diagnosis almost certain


Chronic shortness of breath for exercises.

Patient Data

Age: 45 years
Gender: Male

CT Chest


Bilateral hilar and peri-hilar mass like lesions associated with linear bands of fibrosis and local distortion of lung architecture. Multiple peribronchovascular nodules are present. Features paraseptal and panlobular emphysema. Mediastinal lymphadenopathy with multiple grossly calcified nodes.

Case Discussion

This patient has a known diagnosis of sarcoidosis and this CT study demonstrates features of fibrosis/stage IV. The grossly calcified notes help to think in this diagnosis, but the peribronchovascular nodules are the key finding. 

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