Presentation
This patient is known to have liver cyst, admitted for surgery. X-ray was done as part of preoperative evaluation.
Patient Data
Diffuse bilateral miliary nodules. Bilateral hilar fullness is present.
Miliary intraparenchymal lung nodules seen scattered in both lung fields.
Multiple anterior mediastinal, prevascular, pretracheal, right and left paratracheal, subcarinal and bilateral hilar lymph nodes noted, the largest seen in the subcarinal region measuring 1.7 cm in its short axis.
Diffuse nodular tiny hypodense lesions involving the enlarged spleen.
A well defined fluid attenuation lesions seen, mostly representing simple liver cyst. Tiny hypodensities diffusely involving the liver are also present.
Case Discussion
This patient is well looking and the chest findings are incidental. The constellation of CT findings, including the miliary lung nodules, the hilar and paratracheal lymph nodes is this young female highly suggests sarcoidosis. Endotracheal biopsy reveals a noncaseating granuloma confirming sarcoidosis.