CTICasesNivolumab-Induced Sarcoid-like Reaction
Imaging findings
Diffuse miliary nodular pattern across the lungs, sometimes accompanied by septal lines and fissure thickening.
Key takeaways
Patients undergoing immune checkpoint inhibitor therapy (e.g., nivolumab for melanoma) can develop a sarcoid-like reaction. This mimics miliary metastases or infectious processes like TB, but patients are often less symptomatic than would be expected with extensive miliary disease. Lavage typically reveals an overwhelming number of macrophages without organisms or malignant cells.
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