CTICasesAlveolar Sarcoidosis
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Imaging findings
Chest radiography shows peripheral areas of consolidation in the upper and middle lung zones with associated superior displacement of the hila, indicating upper lobe volume loss. Chest CT characterizes these areas of consolidation as having surrounding, tiny, branching "tentacles of nodularity" extending into the adjacent lung parenchyma, highly reminiscent of the "sarcoid galaxy" sign. Mediastinal and hilar lymphadenopathy are also present, and the patient had elevated angiotensin-converting enzyme (ACE) levels.
Key takeaways
Alveolar sarcoidosis is an atypical manifestation of sarcoidosis characterized by mass-like alveolar consolidation simulating pneumonia or lymphoma. The key to the diagnosis is recognizing the surrounding "sarcoid galaxy" sign, which consists of a central mass-like consolidation formed by coalesced granulomas surrounded by numerous satellite micronodules resembling tentacles.
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