CTICasesPleural Sarcoidosis
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Imaging findings
Chest CT demonstrates extensive, highly asymmetric nodularity and plaque-like thickening along the left visceral and parietal pleura (including the mediastinal pleural surface) associated with bilateral hilar, mediastinal, and subcarinal lymphadenopathy. Follow-up imaging after treatment shows near-complete resolution of the pleural pseudoplaques.
Key takeaways
Pleural involvement is a rare and unusual manifestation of sarcoidosis, occurring in less than 5% of patients, and typically presenting as pleural effusions or nodular pleural thickening (pseudoplaques) that can mimic pleural metastasis, lymphoma, or mesothelioma. Recognition of co-existing typical lymphadenopathy and classic biopsy findings (such as skin plaque biopsies) can prevent diagnostic delays and guide appropriate steroid or immunomodulatory therapy.
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