CTICasesBerylliosis Presenting as Dense Mediastinal Lymphadenopathy without Lung Involvement
Imaging findings
Contrast-enhanced chest CT demonstrates normal lung parenchyma without nodules or fibrosis, but reveals diffusely dense, non-enlarged mediastinal and hilar lymph nodes.
Key takeaways
Berylliosis (chronic beryllium disease) is an occupational lung disease caused by exposure to beryllium dust or fumes, which triggers a cell-mediated, granulomatous hypersensitivity reaction that is histopathologically indistinguishable from sarcoidosis. In its early stages, or in patients with lower exposure, the disease can manifest solely as granulomatous mediastinal and hilar lymphadenopathy (which may appear dense due to calcium deposition or metal clearance) without parenchymal lung involvement.
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