CTICasesChronic Beryllium Disease (Berylliosis) Mimicking Sarcoidosis
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Imaging findings
Chest CT images show prominent, dense, and partially calcified mediastinal and hilar lymphadenopathy. The lung parenchyma demonstrates severe peribronchovascular thickening, nodularity, and extensive perihilar and upper lobe fibrosis, matching a pattern typically associated with stage IV sarcoidosis.
Key takeaways
Chronic beryllium disease (berylliosis) can radiologically and histologically mimic sarcoidosis in almost every aspect, presenting with non-caseating granulomas and identical patterns of peribronchovascular fibrosis. Occupational history is critical; individuals working in dental laboratories making prostheses, aerospace, ceramics, or electronics are at risk of beryllium exposure. Diagnosis can be confirmed using a beryllium lymphocyte proliferation test on blood or bronchoalveolar lavage fluid.
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