Case 2

This is an HRCT study of a skeletally mature male, demonstrating bilateral reticulonodular opacities in a peri-lymphatic distribution along the bronchovascular bundles, fissures, septal lines and in the subpleural region. This is giving the appearance of irregular thickening / beading of the interlobar fissures. There is greater involvement of the central and upper lung zones with relative sparing of the lower lung zones. There is also enlargement of the mediastinal and hilar lymph nodes bilaterally. I also note hepatosplenomegaly.

The findings are consistent with multi-system sarcoidosis. I would discuss the case with the referring physician, and advise core biopsy for histological diagnosis.