대한흉부영상의학회 Weekly Chest Cases

Diagnosis: Sarcoidosis
Radiologic Findings: Radiological findings: HRCT scans show fine micronodules widely-spreaded in the whole lungs. The nodules are distributed in a patchy fashion, particularly crowded along the fissure and at some peribronchovascular regions. Areas of ground-glass opacities are also noted. Mediastinal window images showed multiple hilar and mediastinal lymphadenopathy with a homogenous density. Transbronchial lung biopsy and lymph node biopsy revealed noncaseating chronic granulomatous inflammation consistent with sarcoidosis.
Brief Review: In this case, the distribution of micronodules apparently mimics random distribution that is frequently seen in miliary tuberculosis or hematogenous metastasis. However, the pattern of patchy perilymphatic distribution is obvious along the fissures and at the peribronchovascular areas. Other diseases with micronodules that show perilymphatic distribution include silicosis (or coal-worker’s pneumoconiosis) and lymphangitic metastasis.
References: Please also refer to Case 18, Case 53, Case 98, Case 129, Case 329, Conference2001Spring_12 .
Keywords: Lung, Connective tissue diseases, Sarcoidosis ,

대한흉부영상의학회 Korean Society of Thoracic Radiology