Sarcoidosis involves the bronchi or lung in more than 90 percent of patients and intrathoracic manifestations are protean, ranging from asymptomatic bilateral hilar lymphadenopathy
to chronic, progressive, (ultimately fatal), respiratory insufficiency.
It is generally observed in young adults (20-40 years old), and it often presents with bilateral hilar lymphadenopathy
, pulmonary infiltration, and skin and ocular involvement.
Plain computed tomography revealed small, diffuse, reticular small nodular lesions, ground glass appearance, mediastinal and bilateral hilar lymphadenopathy
, and bilateral pleural effusion (Figure 1a).
The chest computed tomography (CT) showed right lower lobe mass with an irregular cavity, bronchial stenosis, mediastinal and right hilar lymphadenopathy
Sarcoidosis rarely exhibits unilateral pleural effusion and usually manifests with bilateral interstitial lung disease, hilar lymphadenopathy
, and non-necrotizing granulomas.
3% (22), miliary shadows 12% (9), and hilar lymphadenopathy
CECT of the chest did not reveal any tracheobronchial narrowing, mediastinal or hilar lymphadenopathy
, or involvement of mediastinal vessels, heart, and esophagus.
The CT scan confirmed the stability of the pulmonary nodules with no changes to heart size and no evidence of mediastinal or hilar lymphadenopathy
He had been attending our clinic regularly and remained well, but on a visit 4 years later possible recurrence was considered--with hilar lymphadenopathy
noted on his chest radiograph.
Chest computed tomography scan showed right hilar lymphadenopathy
and local plural thickening in posterior part of left hemithorax.
Followup computed tomography (CT) (Figure 2) of the chest with contrast revealed multiple pulmonary nodules with a dominant right middle lobe mass (5x4x3cm), as well as abnormal mediastinal and bilateral hilar lymphadenopathy
, concerning for a neoplastic process.
On chest X-ray examination, bilateral hilar lymphadenopathy
(BHL) is common, as are nodules, which predominantly affect the upper lobes.