CTICasesSarcoidosis with Airway Compression and Air Trapping
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Imaging findings
A 77-year-old patient with sarcoidosis presented with hilar fullness and middle lobe atelectasis on chest radiograph. CT confirmed hilar lymphadenopathy (some with central calcification) and demonstrated significant air trapping on expiration, along with narrowing of large airways (e.g., upper lobe bronchus and right middle lobe bronchus) due to extrinsic compression. PET showed avid FDG uptake in the lymph nodes.
Key takeaways
Sarcoidosis, a granulomatous disease, can cause significant hilar and mediastinal lymphadenopathy. These enlarged nodes can lead to extrinsic compression of large airways, resulting in air trapping and/or atelectasis. Sarcoid lymph nodes are often FDG-avid on PET, which can mimic lymphoma.
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