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Advanced Sarcoidosis with PMF

Imaging findings

Chest radiograph and CT show bilateral, dense, symmetric perihilar masses extending into the upper lobes (progressive massive fibrosis), low lung volumes, and peripheral compensatory emphysema in a patient with sarcoidosis.

Key takeaways

Advanced sarcoidosis (Stage IV) can progress to progressive massive fibrosis (PMF). This presents as large, conglomerate perihilar masses that contract the upper lobes, leading to marked volume loss and peripheral emphysema.

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