This is quite a difficult chest case of a young adult presenting with pulmonary hypertension stigmata. The lungs are not fibrotic and show a few scattered small calcified granulomas and widespread centrilobular soft ground-glass opacities, which can be seen in severe pulmonary hypertension of any cause. Enlarged lymph nodes are also nonspecific and can be seen in PAH of multiple causes. 

Diagnosis of sarcoidosis was clinically suspected and further confirmed on histopathology, but hard to be inferred on imaging.  

Please refer to a companion case on pulmonary veno-occlusive disease to see the subtle differences from this case (septal thickening and mosaicism).