023Lu Sarcoidosis with Wide Variety of Nodules

The frontal CXR shows subtle nodular changes in the right upper peripheral lung field (red circles) .

 

CXR FRONTAL
SARCOIDOSIS – CHARACTERISTIC NODULES
Ashley Davidoff MD

The CT examination scout film confirms 3 major regions of nodular change

3 MAJOR REGIONS OF NODULAR CHANGE
SARCOIDOSIS – CHARACTERISTIC NODULES
Ashley Davidoff MD

The lateral examination shows 3 regions of nodular changes (red arrowheads)

3 MAJOR REGIONS OF NODULAR CHANGE
Ashley Davidoff MD

The Sagittal CT examination scout film confirms 3 major regions of nodular change in the posterior and superior segment of the RUL along the confluence of the right major and minor fissure and in the posterior segment of the left upper lobe peripherally.

CT – 3 MAJOR REGIONS OF NODULAR CHANGE ON THE LATERAL CXR
Ashley Davidoff MD

The axial images show a variety of characteristic changes including;

Ground glass opacity
Stellate or flame shaped nodules
Semi Solid nodules
Fissural based nodules
Subpleural nodules
Micronodules along the
lymphovascular and
bronchovascular bundles of the secondary lobule
Calcified nodule some of which are surrounded by soft tissue of the granuloma

FISSURAL BASED NODULES
Ashley Davidoff MD

 

PLEURAL BASED NODULE (red arrow) and FISSURAL NODULES  (green arrow) –
Ashley Davidoff MD
MICRONODULES ALONG THE LYMPHOVASCULAR (blue arrows) AND BRONCHOVASCULAR BUNDLES (red arrow) OF THE SECONDARY LOBULE
Ashley Davidoff MD
THICKENING OF THE BRONCHOVASCULAR BUNDLES 
Ashley Davidoff MD
STELLATE OR FLAME SHAPED NODULE, (blue arrow), GROUND GLASS NODULES,(yellow arrows) and BRONCHOVASCULAR MICRONODULES (red arrows)
Ashley Davidoff MD
STELLATE OR FLAME SHAPED NODULE
Ashley Davidoff MD
STELLATE OR FLAME SHAPED NODULE
Ashley Davidoff MD
GROUND GLASS OPACITY
Ashley Davidoff MD
SEMISOLID NODULE (red arrow) and FISSURAL NODULE (green arrow)
Ashley Davidoff MD
CALCIFIED NODULES NOTE MEDIAL NODULE IS SURROUNDED BY SOFT TISSUE OF THE GRANULOMA (green arrow)
Ashley Davidoff MD

There are small calcified nodes in the mediastinum, but no significant pathologic adenopathy

SMALL CALCIFIED LYMPH NODES
Ashley Davidoff MD

No obvious cardiac nor splenic involvement is noted

NORMAL LIVER AND SPLEEN
Ashley Davidoff MD