Active right ventricular cardiac sarcoidosis

Discussion:

This case demonstrates cardiac sarcoidosis manifesting predominantly in the right ventricle in addition to lung involvement.

MRI is the radiological modality of choice to evaluate for cardiac sarcoidosis. Typical findings include nodular mid-wall hyperintense foci on black blood T2-weighted imaging, areas of focal myocardial thickening and delayed enhancement, which may be seen in various patterns, but is most commonly either mid-wall or transmural.

Dynamic perfusion can be a useful adjunct to differentiate sarcoidosis from infiltrative masses such as lymphoma. 

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