CTICasesNodular Sarcoidosis with Galaxy Sign
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Imaging findings
Chest CT reveals multiple large, bilateral, mass-like nodular areas of consolidation in an upper-lobe predominant distribution. These confluent masses are surrounded by countless tiny satellite micronodules, creating the characteristic "sarcoid galaxy sign," with additional nodules distributed along the pleural fissures.
Key takeaways
Nodular sarcoidosis is an atypical presentation of sarcoidosis that can mimic primary lung malignancy or metastatic disease on imaging. The "sarcoid galaxy sign" represents a large, confluent granulomatous mass surrounded by smaller, coalescing satellite granulomas. Biopsy of these lesions typically confirms non-necrotizing granulomatous inflammation, and the clinical course is generally benign and responsive to steroids.
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