CTICasesSarcoidosis with Large Nodular Perilymphatic Pattern
Imaging findings
Chest radiograph and CT demonstrate numerous large rounded nodules distributed in a perilymphatic pattern along the bronchovascular bundles and fissures with a perihilar predominance, coalescing in some areas. The nodules are unusually large for typical sarcoidosis, each individually appearing more like a hematogenous metastasis or lymphoma deposit.
Key takeaways
Sarcoidosis typically produces small perilymphatic nodules, but can occasionally manifest with unusually large coalescing perilymphatic nodules that may mimic lymphoma or hematogenous metastases. The perilymphatic distribution and perihilar clustering remain the key diagnostic clues. This nodular variant of sarcoidosis has a flame-like radiation from the hilum pattern, which should be recognized to avoid unnecessary invasive workup.
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