CTICasesSarcoidosis with Galaxy Sign
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Imaging findings
Chest radiograph demonstrates striking bilateral hilar and right paratracheal lymphadenopathy with overlying nonsegmental parenchymal opacities. Chest CT shows these larger opacities are composed of dense, mass-like coalescent nodules with irregular, nodular borders and surrounding tiny satellite nodules, demonstrating the classic galaxy sign.
Key takeaways
The galaxy sign is an established CT finding in pulmonary sarcoidosis representing clusters of tiny interstitial granulomas that coalesce to mimic large, mass-like consolidations. Identifying this sign in the setting of symmetric hilar and mediastinal lymphadenopathy is highly suggestive of sarcoidosis and helps prevent unnecessary workup for lung malignancy.
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