CTICasesGranulomatosis with Polyangiitis with Perihilar Consolidation
Imaging findings
Chest CT demonstrates bilateral, symmetric, hilar-hugging areas of consolidation with irregular, flame-like borders radiating into the lung parenchyma. Faint centrilobular micro-nodules are also noted along the margins of the consolidation.
Key takeaways
Granulomatosis with polyangiitis can uncommonly present with a perihilar-hugging, flame-like pattern of consolidation. This appearance mimics sarcoidosis, Kaposi sarcoma, or lymphoma (the "X-man" sign), and should be kept in the differential diagnosis of central, symmetric lung consolidation.
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