CTICasesSarcoidosis
Imaging findings
Chest CT demonstrates bilateral hilar and mediastinal lymphadenopathy with a "powdered sugar" or "putty" appearance, characterized by faint, homogeneous, and diffuse calcification with a slightly denser calcified core. Lung windows demonstrate a classic perilymphatic distribution of small pulmonary nodules.
Key takeaways
The homogeneous, fine, "powdered sugar" or "putty" calcification of thoracic lymph nodes is highly suggestive of sarcoidosis. Over time, these calcified nodes may progress to show more classic dense central or eggshell calcification patterns.
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