Sarcoidosis is a multisystemic granulomatous disorder that usually presents with bilateral hilar lymphadenopathy and micronodules in a perilymphatic distribution. It is unusual to find ground glass opacities, consolidations and cavities on imaging in the absence of superimposed infections. These atypical findings are difficult to classify in any category of the Scadding staging system. Cavitary lesions can develop in advanced sarcoidosis due to chronic granulomatous inflammation and ischemia. Ground glass opacities are formed due to the confluence of granulomas or fibrotic lesions. Sarcoidosis can be confirmed by the presence of non-caseating epithelioid cell granulomas on Endobronchial Ultrasound (EBUS) guided Transbronchial Needle Aspiration (TBNA) of the thoracic lymph nodes. We present an atypical case of pulmonary sarcoidosis with gradual progression from ground glass opacities to peribronchial nodules and cavities of different sizes in the absence of any associated symptoms.
Nidhi Kalra (Fri,) studied this question.
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