Computed Tomography Observations Indicating Pulmonary Sarcoidosis

Abstract

CT imaging excels in depicting symmetric lymph node swelling in the hilum and mediastinum, especially with contrast-enhanced
CT. High-resolution CT findings in the lung fields typically show broad interstitial thickening centered around irregular thickening of the peribronchovascular interstitium, with granular or nodular opacities predominantly distributed in the upper lung fields. In the peripheral regions,
irregular thickening of the peribronchovascular interstitium manifests as centrilobular branching nodular opacities. Granular and nodular
opacities spread along the lymphatic pathways within the broad interstitium. Sometimes, consolidation or mass-like opacities may be present
(pseudo-alveolar pattern). Clustering of fine branching nodular opacities may occasionally resemble a galaxy sign on CT. While examples
progressing to fibrosis are rare, advanced cases may exhibit upper lobe contraction with reticular opacities and cysts around the bronchovascular bundle. Rarely, findings resembling a honeycomb lung may be observed in the lung bases.