CTICasesSarcoidosis with Subpleural Nodules (Pseudo Plaques)
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Imaging findings
An old radiograph shows subtle peripheral nodularity. CT demonstrates numerous subpleural nodules, appearing as 'pseudo plaques' lining the pleura, which are interpreted as per lymphatic nodules or enlarged intrapulmonary lymph nodes. Mediastinal and hilar lymphadenopathy are also present. The nodules appear less dense and more irregular on standard kernels compared to the high attenuation often seen in silicosis.
Key takeaways
Sarcoidosis, a systemic granulomatous disease, can manifest with characteristic per lymphatic nodules that may cluster in the subpleural regions, forming what are sometimes referred to as 'pseudo plaques.' It is important to differentiate these from the dense, often calcified, plaques seen in silicosis. While sarcoidosis often presents with mediastinal and hilar lymphadenopathy, the nodules themselves typically lack high attenuation. The morphology of these nodules in sarcoidosis can be quite variable.
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