CTICasesBilateral Mycetomas in Cavitary Sarcoidosis
Imaging findings
Chest radiograph demonstrates symmetrical upper lung zone scarring, severe traction bronchiectasis, and bilateral upper lobe cavitary lesions. Within each cavity, there is a large, rounded, mobile soft-tissue mass surrounded by a thin crescent of air, representing bilateral, symmetrical mycetomas.
Key takeaways
Symmetrical upper lobe cavitation and scarring are characteristic of end-stage, fibrotic sarcoidosis. These pre-existing chronic cavities are highly susceptible to colonization by Aspergillus species, leading to the formation of mycetomas, which classically present on imaging with the Monod sign of a mobile intracavitary mass outlined by an air crescent.
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