Presentation
Chronic shortness of breath for exercises.
Patient Data
Age: 45 years
Gender: Male
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Axial lung window

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.