Sarcoidosis

Case contributed by Frank Gaillard
Diagnosis almost certain

Patient Data

Age: Adult
x-ray

Coarsened pulmonary parenchymal markings particularly in the upper zones with mediastinal nodal enlargement. 

18 months later

ct
  • extensive retractile emphysema in the posterior periphery of both apices with multiple thin-walled air cysts
  • fibrosis in the mid to lower lung zones
  • bilateral lower lobe bronchiectasis
  • extensive lower lobe micronodularity
  • ground-glass opacity in the lingula and generalized more diffuse ground-glass opacity
  • extensive basilar pleural thickening
  • adenopathy
    • prevascular
    • right paratracheal (conglomerate mass) of nodes. 
    • numerous subcentimeter axillary nodes bilaterally

Case Discussion

End-stage pulmonary sarcoidosis established clinically.

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