case_images: PMC11758509_01
case_images: Diffuse infiltrates throughout the left lung along with patchy atelectasis at the right lung base. There is a 2-cm nodular focus overlying the left lower lobe suspicious for a mass.
case_images: 10.1177_23247096251313630-fig1.jpg
case_images: PMC11758509_01_10.1177_23247096251313630-fig1.jpg
case_images: fig1-23247096251313630
case_images: Initial chest radiography revealed diffuse infiltrates in the left lung, a 2-cm nodular opacity in the left lower lobe, and patchy atelectasis at the right lung base (Figure 1).
case_images: Extensive interstitial reticular thickening, concerning for lymphangitic carcinomatosis along with mediastinal and hilar lymphadenopathy.
case_images: 10.1177_23247096251313630-fig2.jpg
case_images: PMC11758509_01_10.1177_23247096251313630-fig2.jpg
case_images: fig2-23247096251313630
case_images: A computed tomography (CT) of the thorax with contrast demonstrated extensive interstitial reticular thickening, raising concern for lymphangitic carcinomatosis, along with mediastinal and hilar lymphadenopathy (Figure 2).
case_images: Small, non-obstructing endobronchial polyps at the left upper and lower lobe orifices, as well as a partially obstructing polypoid lesion at the right lower lobe orifice.
case_images: 10.1177_23247096251313630-fig3.jpg
case_images: PMC11758509_01_10.1177_23247096251313630-fig3.jpg
case_images: fig3-23247096251313630
case_images: Consequently, the patient underwent bronchoscopy, which revealed friable mucosa throughout the airway with small, non-obstructing endobronchial polyps at the left upper and lower lobe orifices, as well as a partially obstructing polypoid lesion at the right lower lobe orifice (Figure 3).
case_images: Confluent non-caseating granulomas consistent with sarcoidosis.
case_images: 10.1177_23247096251313630-fig4.jpg
case_images: PMC11758509_01_10.1177_23247096251313630-fig4.jpg
case_images: fig4-23247096251313630
case_images: Multiple transbronchial and endobronchial biopsy specimens showed confluent non-caseating granulomas consistent with sarcoidosis (Figure 4).
case_images: Resolution of lymphadenopathy and remarkable improvement of the confluent areas of consolidation and diffuse peribronchovascular interstitial changes.
case_images: 10.1177_23247096251313630-fig5.jpg
case_images: PMC11758509_01_10.1177_23247096251313630-fig5.jpg
case_images: fig5-23247096251313630
case_images: A repeat high-resolution CT of the chest showed notable improvement in mediastinal and hilar lymphadenopathy, as well as resolution of areas of consolidation and diffuse peribronchovascular interstitial changes (Figure 5).