CTICasesNecrotizing Sarcoid Granulomatosis with CNS and Pulmonary Involvement
Imaging findings
A patient with a prior pineal-region brain lesion showing granulomas with focal necrosis on biopsy develops progressive bilateral multifocal, nodular, non-segmental consolidative opacities on chest radiograph and CT, some containing air bronchograms, with mild associated intrapulmonary lymphadenopathy.
Key takeaways
Necrotizing granulomas involving both the CNS and lung, without organisms identified and without features of GPA (no renal disease, negative serologic workup), support a diagnosis of necrotizing sarcoid granulomatosis -- regarded by many pathologists as part of a continuum with classic sarcoidosis rather than a truly separate entity -- and the pulmonary disease improved substantially with corticosteroid therapy.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Radiation Recall PneumonitisILD
- Disseminated Candidiasis with Miliary Pulmonary NodulesInfection
- Marijuana-Associated Aspergillus BronchitisInfection
- SVC Syndrome with Venous-Enhancement Pseudo-Sclerotic Bone MetastasesArtifact
- Disseminated Coccidioidomycosis Mimicking Metastatic CancerInfection
- LVAD Outflow Cannula Extraluminal Fluid Mimicking ThrombusArtifact
- LVAD Driveline Infection Extending to the Outflow CannulaInfection
- Fatal Reexpansion Pulmonary Edema with Contralateral ARDSInflammatory
See all cases from July 19, 2018 →
Related Autoimmune cases
- Granulomatosis with Polyangiitis (GPA)
- Extensive Calcinosis in Dermatomyositis
- Behcet Syndrome with Right Ventricular Thrombus and Pulmonary Infarction
- Relapsing Polychondritis
- Tracheal Involvement of Granulomatosis with Polyangiitis (GPA)
- Eosinophilic Granulomatosis with Polyangiitis (EGPA) with Pulmonary Hemorrhage