Stage II sarcoidosis with both nodal and parenchymal disease. Chest x-ray demonstrates upper zone reticulonodular opacities with extensive mediastinal and hilar nodal enlargement. CT of the chest demonstrates diffuse areas of nodularity predominantly in a peribronchial distribution with patchy areas of consolidation particularly in the upper lobes. There is some surrounding ground glass opacities. No gross reticular changes to suggest fibrosis. Marked mediastinal and perihilar adenopathy is present. Final Diagnosis - Bronchial biopsy: several multinucleated giant cells identified in a chronic inflammatory, non-necrotizing background; observations are consistent with sarcoidosis; special stains pending.
Picture 1; Picture 2; Picture 3; Picture 4; Picture 5; Picture 6 Case Sarcoidosis courtesy of Dr. Frank Gaillard, Radiopaedia.org