Presentation
Had a CT abdomen for another reason and extensive mediastinal lymph nodes were noted. Further evaluation with dedicated chest imaging was recommended
Patient Data
Bilateral hilar lymphadenopathy is suspected. A few rounded opacities/nodules are also noted, mainly in the left upper lobe. Further evaluation with dedicated chest CT was recommended.
Bulky bilateral hilar, subcarinal, AP window and right lower paratracheal lymphadenopathy is noted.
Bibasilar reticulonodular densities and faint groundglass opacities, suggesting interstitial lung disease.
There are multiple bilateral solid pulmonary nodules, predominating in the mid and lower lung zones, measuring up to 1 cm. All the nodules are either peribronchovascular or subpleural/parafissural (perilymphatic distribution) . Three nodules in the left lower lobe, 1 nodule in the right lower lobe and 2 nodules in the right middle lobe.
Case Discussion
The described findings are suggestive of stage II sarcoidosis. Given the near 1 year stability of the findings at the lung bases in this case, lymphoproliferative disorders and metastatic disease are less likely.
Additional differential diagnostic consideration includes IgG4 disease.
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