CTICasesSarcoidosis
Imaging findings
Serial chest radiographs and CT scans show progressive volume loss, upper lobe retraction, and development of large, bilateral perihilar masses of fibrous tissue (progressive massive fibrosis pattern) containing calcification, associated with eggshell calcified mediastinal/hilar lymph nodes and severe pleural thickening.
Key takeaways
Stage IV sarcoidosis represents end-stage pulmonary fibrosis. It typically manifests with upper-lobe-predominant scarring, bronchovascular bundle distortion, and large conglomerate masses mimicking progressive massive fibrosis (PMF). Eggshell calcification of lymph nodes is a classic late finding.
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