40-year-old female patient presenting with cough and dyspnea
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Multiple pathologically enlarged bilateral hilar and mediastinal lymph nodes are seen at pre-vascular, retrocaval, pre-carinal, sub-carinal and zygo-oesophagal locations. The largest at sub-carinal location measures 4 X 2.5 cm.
Right upper lobe anterior segment and middle lobe peri-bronchial thickening with reticulo-nodulation and thickening of interlobular septae.
CT findings impressive of stage II sarcoidosis (nodal enlargement and parenchymal disease).
A transbronchial biopsy was done with examined sections showing bronchial tissue portions showing non-necrotizing naked granuloma composed of epithelial cells, multinucleated giant cells, frequently of the Langhan`s cell type and few lymphocytes, associated with fibrosis. No neoplasia. Final pathological diagnosis:non-caseating granulomas (sarcoidosis).