CTICasesSarcoid-Like IRIS in HIV
Imaging findings
CT chest in an HIV-positive patient who recently initiated antiretroviral therapy (ART) shows new, bilateral perilymphatic nodules, subpleural thickening, and symmetric mediastinal and hilar lymphadenopathy, representing a sarcoid-like immune reconstitution inflammatory syndrome (IRIS).
Key takeaways
IRIS is a pathological inflammatory response that occurs after starting ART in HIV patients. It can present as a sarcoid-like granulomatous reaction in the lungs and mediastinum, representing a hyper-inflammatory response to active or occult mycobacterial or fungal infections (like histoplasmosis).
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