CTICasesSkeletal Sarcoidosis
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Imaging findings
Radiograph of the right shoulder shows an ill-defined, lytic lesion in the proximal humerus. PET/CT scan demonstrates multiple hypermetabolic lytic bone lesions in the humerus, acetabulum, and iliac wing. Extensive metabolic activity is also present in bilateral hilar and mediastinal lymph nodes, as well as multiple coalescent pulmonary nodules. Biopsy of the osseous and pulmonary lesions demonstrates non-necrotizing granulomas.
Key takeaways
Skeletal sarcoidosis is an uncommon manifestation of systemic sarcoidosis that can present as multiple painful or painless lytic bone lesions, often mimicking metastatic lung cancer or myeloma on PET/CT. Osseous biopsies showing non-necrotizing granulomas and matching systemic imaging features are diagnostic of sarcoidosis once infection is ruled out.
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