CXR Case 029

There is bilateral hilar adenopathy and bands of atelectasis in both lung bases.

*Lung parenchyma looks normal.

This is sarcoidosis (stage 1 on radiological classification)

*Important differentials to consider would be lymphoma and TB *

Lymph node biopsy (these days guided by endobronchial ultrasound) demonstrating non-caseating granuloma is needed to secure the diagnosis

Once the diagnosis is secure, sarcoidosis that is not causing organ damage does not necessary need treatment, ~85% of cases at this stage will resolve spontaneously over 8-12 months.