Case contributed by Stefan Tigges
Diagnosis certain


Known history of sarcoidosis.

Patient Data

Age: 50 years
Gender: Female

Upper lobe predominant pulmonary scarring, but no edema or pneumonia. Biventricular pacemaker appropriately positioned.


Bilateral upper lobe pulmonary fibrosis and perilymphatic pulmonary nodules. No definite lymphadenopathy. Biventricular pacemaker.

Case Discussion

Although the lungs are the most commonly affected organ in sarcoidosis, about 25% of cases will have cardiac involvement, but most cardiac sarcoid is asymptomatic. Although not visible on a chest x-ray, non-caseating granulomas can involve the cardiac conduction system, which may result in fatal arrhythmias. In this case, the patient did have involvement of the cardiac conduction system, necessitating pacemaker placement.

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