CXR Case 032

There are multifocal bilateral reticulonodular air-space opacities, predominantly perihilar and mid zone distribution.

This gentleman has long standing pulmonary fibrosis caused by sarcoidosis.

There is marked pulmary parenchymal infiltrate and established fibrosis (sarcoidosis stage IV on radiological classification).

The cause of his syncope could be from cardiac sarcoid causing conduction defects.

*Whilst widely quoted in text books, the radiological stage (I to IV) for sarcoidosis does not take into account extra-thoracic manifestations of sarcoid and it does not necessarily influence management.*