Case ReportRadiographic features of primary cavitary sarcoidosis with “lotus seed-like” manifestations
Introduction
Sarcoidosis is a systemic disease of unknown cause resulting in the development of non-caseating granulomas that can affect all organs of the body, but with predominant pulmonary involvement. Pulmonary sarcoidosis has a wide variety of radiographic features. The most common computed tomography (CT) feature of pulmonary sarcoidosis is irregularly-thickened bronchovascular bundles that pathologically present as the presence of peribronchial granulomas.1 However, cavitary pulmonary lesions are uncommon, and in particular, true primary cavitary sarcoidosis extremely rare.2, 3, 4
In this report, we present a case of a primary cavitary sarcoidosis with “lotus seed-like” manifestations.
Section snippets
Case report
A 34-year-old man presented with cough of a few days duration. He had no past medical history. Laboratory data on admission were as follows: haemoglobin, 14.6 g/dl; white blood cell count, 7500/l; C-reactive protein, 0.89 mg/dl; angiotensin-converting enzyme, 19.2 (8.3–21.4 IH/U); calcium, 9.7 (8.7–10.3 mg/dl); tuberculin test, negative; and QuantiFERON tuberculosis, negative. Sputum cultures repeatedly showed negative results for fungi, bacteria, and Mycobacterium tuberculosis.
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Discussion
Characteristic radiological findings associated with sarcoidosis have been well described and the findings include bilateral hilar lymphadenopathy and parenchymal abnormalities.5, 6, 7 As sarcoid granulomas in the lung are typically distributed along the lymphatic vessels, multiple small nodules in a peribronchovascular distribution along with irregular thickening of the interstitium are typical CT findings of sarcoidosis. With advanced disease, architectural distortion, bronchiectasis, and
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