Presentation
Known case sarcoidosis , presented with shortness of breath.
Patient Data
Diffuse scattered granular and satellite shaped opacities, giving the galaxy sign appearance, seen bilaterally predominantly in upper lobes, with peripheral patchy ground glass opacities, and multiple bilateral peripheral perilymphatic subpleural nodules with beaded fissural appearance.
Multiple enlarged hilar and mediastinal lymph nodes are noted, some of them show coarse calcification, the largest seen subcarina measures about 3 cm in short axis.
Confluent symmetrical consolidative changes noted radiating from both hila toward the upper lobes, suggesting upper lobes fibrosis associated with surrounding architectural distortion.
No honeycombing or bronchiectasis. No pericardial or pleural effusion. No pneumothorax.
Features are suggestive of sarcoidosis complicated by upper lobe fibrosis.
Case Discussion
Sarcoidosis is an idiopathic systemic disorder of noncaseating granulomas.
Pulmonary sarcoidosis may progress to pulmonary fibrosis, in which the fibrotic changes have a mid and upper-lung predominance and can produce progressive massive fibrosis.
Sarcoidosis may involve other organs, including the spleen, brain, and rarely bone.
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