CTICasesChronic Berylliosis
Imaging findings
A patient with several years of stable diffuse fine nodular lung disease had CT showing fine nodules with a perilymphatic (peribronchovascular and subpleural) distribution that appeared somewhat lazy and stringy, with modest mediastinal lymphadenopathy but no classic sarcoid-like "icing sugar" nodularity; biopsy had not yet confirmed a granulomatous process, but a beryllium lymphocyte proliferation/sensitization test was positive. The patient's occupational history included work at nuclear construction sites.
Key takeaways
A stable, longstanding perilymphatic fine nodular pattern in a patient with occupational beryllium exposure (such as nuclear industry work) and a positive beryllium sensitization test supports a diagnosis of chronic berylliosis, a granulomatous lung disease that can closely mimic sarcoidosis radiographically but is distinguished by the exposure history and sensitization testing.
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