대한흉부영상의학회 Korean Society of Thoracic Radiology

대한흉부영상의학회 Weekly Case 메뉴

Close

대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
Advanced Search..

Close

Weekly Chest CasesArchive of Old Cases

Case No : 1482 Date 2026-03-16

  • Courtesy of Hyungin Park / Samsung Medical Center
  • Age/Sex 30 / M
  • Chief ComplaintDyspnea
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Sarcoidosis
Radiologic Findings
Fig 1. Chest PA shows bilateral hilar bulding opacity
Fig 2. Axial CT images with mediastinal setting show bilateral multiple conclomerated mediastinal lymphadenopathy
Fig 3. Axial CT images with lung setting show multifocal patchy GGO in both lung
Brief Review
For diagnostic evaluation, the patient underwent EBUS biopsy of the mediastinal lymph nodes, which revealed non-caseating granulomas, suspicious for sarcoidosis. Based on these findings, a final diagnosis of sarcoidosis was made
Sarcoidosis is a multisystem granulomatous disorder characterized by the development of noncaseating granulomas in various organs. The clinical features are often nonspecific (e.g., cough, dyspnea, and chest pain) and can be seen in 9%–19% of cases.
Sarcoidosis usually presents with asymptomatic lymphadenopathy with or without pulmonary infiltrations. Bilateral hilar lymphadenopathy is the most common radiological finding. Mediastinal lymphadenopathy can also be seen and is often associated with the presence of pulmonary infiltrates. The presence of pulmonary infiltrations have been reported in approximately 60% of patients.
Additionally, it can present with small nodules that mostly measure less than 3 mm in diameter and nodular thickening along the lymphatics in the bronchovascular sheath and, to a lesser extent, in the interlobular septa and subpleural lung regions. This distribution is referred to as perilymphatic. In addition, upper lobe predominance is common, but this finding can vary. Most sarcoid granulomas can resolve spontaneously; however, sarcoid granulomas can also progress to fibrosis
Given the high probability of spontaneous resolution in patients with newly diagnosed early-stage pulmonary sarcoidosis, it may be preferable to monitor the condition without applying any specific treatment in the early stages. Patients showing progression of symptoms, worsening radiographic appearance, or decreasing pulmonary function should be considered for treatment. Systemic corticosteroids are the mainstay of treatment for sarcoidosis.
References
1. Ganeshan D, Menias CO, Lubner MG, et al. Sarcoidosis from head to toe: what the radiologist needs to know. Radiographics 2018; 38:1180–1200.
2. Park HJ, Jung JI, Chung MH et al. Typical and Atypical Manifestations of Intrathoracic Sarcoidosis. Korean J Radiol. 2009 Nov-Dec;10(6):623-631.
3. Koyama T, Ueda H, Togashi K, Umeoka S, Kataoka M, Nagai S. Radiologic manifestations of sarcoidosis in various organs. Radiographics 2004;24:87–104.
Keywords

No. of Applicants : 93

▶ Correct Answer : 58/93,  62.4%
  • - Chonnam National University Hwasun Hospital , Korea (South) KWANGKUN CHO
  • - Kyeongpook National University Hospital , Korea (South) JOHN BAEK
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - The University of Tokyo Hospital , Japan ISSEI FUKUDA
  • - ZIGONG TCM HOSPITAL OF CHINA , China CAO CUN YOU
  • - , Japan HIROKI SAKURADA
  • - BNH VIN A KHOA TNH H TNH , Viet Nam ANH TRAN
  • - , Korea (South) KYUNG HYUN WOO
  • - , Italy PAOLO BALDASSARI
  • - Chonnam National University Hospital , Korea (South) JUNYEOL YANG
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - Kyung Hee University Medical Hospital , Korea (South) INKEON YEO
  • - Secomedic Hospital , Japan FUMINORI MIYOSHI
  • - Seoul Medical Center , Korea (South) HYUK GI HONG
  • - university of montreal , Canada Andrei Bogdan Gorgos I
  • - QATIF CENTRAL HOSPITAL , Saudi Arabia HANI M ALSALAM
  • - Osaka University , Japan AKINORI HATA
  • - Ajou University Hospital , Korea (South) HAEIN LEE
  • - Chiba University Hospital , Japan HIROKI MIYAZAKI
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Nara Medical University , Japan AYA YAMADA
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - , Korea (South) SEONGJUN JANG
  • - Japanese Red Cross Otsu Hospital , Japan JUN YOSHIDA
  • - Other , Korea (South) CHAEHUN LIM
  • - Other , Korea (South) MARI A
  • - Chonbuk National University Hospital , Korea (South) SEUNG HO LEE
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - , Japan SHUNJIRO NOGUCHI
  • - Etlik City Hospital, Ankara , Turkey MERIC TUZUN
  • - , Korea (South) HEONSEOK LEE
  • - Kyoto City Hospital , Japan AKIHIKO MINAMI
  • - , Japan MASAMICHI IWAI
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Shiga General Hospital , Japan YUSAKU MORIBATA
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Kyung Hee University Medical Hospital , Korea (South) TAE JUN PARK
  • - Samsung Medical Center , Korea (South) DONGYOUNG JEONG
  • - GHICL , France MANUEL TOLEDANO
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - , Japan MATSUNO MAI
  • - Paras hospital, Panchkula , India SHALEEN RANA
  • - Kobe Children , Japan SHUHEI NORIMOTO
  • - Kyung Hee University Medical Hospital , Korea (South) JEONG TAEK YOON
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Samsung Medical Center , Korea (South) SEONGUK KIM
  • - Inje University Ilsan Paik Hospital , Korea (South) SUMIN PARK
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Matsunami General Hospital , Japan TARO TAKEDA
  • - Ehime University , Japan TOMOHISA OKADA
  • - Nara medical university , Japan HIROHIDE WATANABE
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - University of Yamanashi , Japan KOJIRO ONOHARA
  • - Chonnam National University Hospital , Korea (South) JAEBONG YANG
  • - , Japan YUJI OHIZUMI
  • - , Japan YUKIHISA TAKAYAMA
▶ Correct Answer as Differential Diagnosis : 32/93,  34.4%
  • - medical scanning , Japan HIROAKI ARAKAWA
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - Kyoto University Hospital , Japan YUSUKE UTSUNOMIYA
  • - , Korea (South) DONG-HO BANG
  • - Chonnam National University Hospital , Korea (South) HYUNJIN KIM
  • - , Korea (South) DONG HEE LEE
  • - Kyeongpook National University Hospital , Korea (South) JUNGMIN LEE
  • - Chonbuk National University Hospital , Korea (South) EUNCHONG LEE
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - Madras Medical College , India GAUTAMRAMKARTHIK MANOHAR
  • - University of Yamanashi , Japan TAKAAKI HASHIMOTO
  • - University of Yamanashi , Japan HIROYUKI MORISAKA
  • - The Catholic University of Korea Seoul St. Mary , Korea (South) JIHO PARK
  • - University of Yamanashi , Japan HIROAKI WATANABE
  • - Chonbuk National University Hospital , Korea (South) JUNGHOON OH
  • - , Switzerland JULIA LANGHART
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) OHMIN KWON
  • - , Japan KEISUKE OSHIMA
  • - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
  • - GOP Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - Seoul Medical Center , Korea (South) HANSEUL CHO
  • - , Japan TOMOHIRO KAWAJI
  • - Korea University Anam Hospital , Korea (South) KYU-CHONG LEE
  • - Kyoto University , Japan SHO KOYASU
  • - Fukuoka university , Japan KEISUKE SATO
  • - Kantou Rousai Hospital , Japan KAORU SUMIDA
  • - Ehime University , Japan KOTARO MATSUMOTO
  • - Chonbuk National University Hospital , Korea (South) HYEONG RYUN CHO
  • - The Catholic University of Korea Yoeuido St. Mary , Korea (South) CHAWOONG JEON
  • - Jiangsu province hospital , China WANGJIAN ZHA
  • Top
  • Back

Each Case of This Site Supplied by the Members of KSTR.
Copyright of the Images is in the KSTR and Original Supplier.
Current Editor : Eui Jin Hwang, M.D., Ph.D Email : weeklychestcases@gmail.com

This website is optimized for IE 10 and above.