CTICasesNivolumab-induced Sarcoid-like Reaction
Imaging findings
Uniform, fine, miliary-like opacities throughout the lungs. Septal lines and fissure thickening, which appear rapidly. Lavage revealed an overwhelming number of macrophages with no malignant cells or organisms.
Key takeaways
Immune checkpoint inhibitors, specifically nivolumab, can trigger sarcoid-like reactions that mimic miliary metastasis or infection. Patients are often surprisingly asymptomatic despite the extensive radiographic appearance.
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