Sarcoidosis lymph nodes

  • Normal
  • Adenopathy
    • Non Calcified
    • Calcified
      • Stippled
      • Egg Shell

Normal

Adenopathy

Bilateral hilar adenopathy is most common and usually symmetric (50 percent of cases) or the right may be slightly more prominent . Unilateral adenopathy is uncommon (<5 percent of cases).

See Garland Triad, Pawnbrokers Sign and 1,2,3 Sign

Non Calcified

CT with MEDIASTINAL AND HILAR ADENOPATHY
SARCOIDOSIS, ACTIVE – ALVEOLAR FORM
Ashley Davidoff MD

 

Solid

Solid Calcifications

TB

SMALL CALCIFIED HILAR LYMPH NODES
INACTIVE SECONDARY TB WITH EXTENSIVE PARENCHYMAL AND LYMPHOVASCULAR INVOLVEMENT
48-year-old male with history of TB 
Ashley Davidoff MD

See 044Lu

SMALL CALCIFIED HILAR LYMPH NODES TheCommonVein.net
INACTIVE SECONDARY TB WITH EXTENSIVE PARENCHYMAL AND LYMPHOVASCULAR INVOLVEMENT
48-year-old male with history of TB presents with back pain
AP view of the spine shows complex lesion in the right apex characterized by fibronodular opacities. There are scattered calcifications throughout the lungs but some are centered around the lymphatics, including the interlobular septa and centrilobular region
Ashley Davidoff MD

Histoplasmosis

CLACIFIED HILAR NODES
PULMONARY HISTOPLASMOSIS
77-year-old male presents for preop CABG and admitting CXR shows multiple large pulmonary nodules
Chest CT shows innumerable pulmonary nodules ranging from 5mm to 17mms. A few of these nodules are calcified.
CT guided biopsy of the largest irregular nodules in the right lower lobe showed granulomatous pneumonitis with intracellular fungal spores, positive PAS and GMS most compatible with histoplasmosis
Ashley Davidoff MD

Amyloid

LVE
CALCIFIED NODES OF AMYLOIDOSIS
72-year-old male with history of an amyloidoma removed with right middle lobectomy
The CXR shows left ventricular enlargement
The current CT is characterized by stable small hilar nodal calcifications that likely represent amyloidosis
There are calcifications on right side of the left atrium and by the left heart border with associated focal regions of pericardial thickening. Involvement of the pericardium may be due to amyloidosis. However the LS calcification could also be post op and the calcification along on the left heart border could also be branch of circumflex with unusually chunky appearance which would be out of proportion to the degree of calcification elsewhere in the coronaries.
Fat in the LV apex indicates previous LAD territory infarction and likely account for the LVE noted on CXR
Ashley Davidoff MD
CALCIFIED NODES OF AMYLOIDOSIS
72-year-old male with history of an amyloidoma removed with right middle lobectomy
The CXR shows left ventricular enlargement
The current CT is characterized by stable small hilar nodal calcifications that likely represent amyloidosis
There are calcifications on right side of the left atrium and by the left heart border with associated focal regions of pericardial thickening. Involvement of the pericardium may be due to amyloidosis. However the LS calcification could also be post op and the calcification along on the left heart border could also be branch of circumflex with unusually chunky appearance which would be out of proportion to the degree of calcification elsewhere in the coronaries.
Fat in the LV apex indicates previous LAD territory infarction and likely account for the LVE noted on CXR
Ashley Davidoff MD
CALCIFIED NODES OF AMYLOIDOSIS
72-year-old male with history of an amyloidoma removed with right middle lobectomy
The CXR shows left ventricular enlargement
The current CT is characterized by stable small hilar nodal calcifications that likely represent amyloidosis
There are calcifications on right side of the left atrium and by the left heart border with associated focal regions of pericardial thickening. Involvement of the pericardium may be due to amyloidosis. However the LS calcification could also be post op and the calcification along on the left heart border could also be branch of circumflex with unusually chunky appearance which would be out of proportion to the degree of calcification elsewhere in the coronaries.
Fat in the LV apex indicates previous LAD territory infarction and likely account for the LVE noted on CXR
Ashley Davidoff MD

 

Amyloid

58 F Heterogeneous calcifications in mediastinal and hilar adenpathy

 

Egg Shell

Calcified lymph nodes
The A-P and lateral view of the chest is from a patient with sarcoidosis showing classical egg shell calcification of the mediastinal nodes and hilar nodes.
Ashley Davidoff MD TheCommonVein.net 42195c01
UPPER LOBE DOMINANCE, MICRONODULES, FISSURAL INVOLVEMENT, BRONCHIECTASIS
SARCOIDOSIS AND EGG SHELL CALCIFICATION OF THE LYMPH NODES
51-year-old male with Stage 3 Sarcoidosis and egg shell calcification of lymph nodes
Ashley Davidoff MD
SARCOIDOSIS with CENTRILOBULAR MICRONODULES, BRONCHOVASCULAR INVOLVEMENT EGG SHELL CALCIFICATION OF THE LYMPH NODES
51-year-old male with Stage 3 Sarcoidosis and egg shell calcification of lymph nodes
Ashley Davidoff MD

Stippled

CALCIFIED LYMPH NODES, RIGHT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
Ashley Davidoff MD
CALCIFIED LYMPH NODES, RIGHT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
Ashley Davidoff MD
CALCIFIED LYMPH NODES, RIGHT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
Ashley Davidoff MD
CALCIFIED LYMPH NODES, RIGHT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
Ashley Davidoff MD

CALCIFIED LYMPH NODES, LEFT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
Ashley Davidoff MD
CALCIFIED LYMPH NODES, LEFT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
Ashley Davidoff MD
CALCIFIED LYMPH NODES, COMPRESSION LUL BRONCHUS, LEFT EFFUSION
SARCOIDOSIS, STAGE IV, PTX, ENCASEMENT
50-year-old male presents with history of Stage 4 sarcoidosis acute chest pain and dyspnea

Ashley Davidoff MD

 

Egg Shell

Calcified lymph nodes
The A-P and lateral view of the chest is from a patient with sarcoidosis showing classical egg shell calcification of the mediastinal nodes and hilar nodes.
Ashley Davidoff MD TheCommonVein.net 42195c01
SARCOIDOSIS AND EGG SHELL CALCIFICATION OF LYMPH NODES
79 year old male with sarcoidosis and egg shell calcification of the hilar and mediastinal nodes
Ashley Davidoff MD