Respi 01

Case courtesy of Dr Azril

37 years old, Pulmonary sarcoidosis with Extrapulmonary – gut involvement ( presented with chronic diarrhoea) at HTJ Seremban. Rigid bronchoscopy n& cryobiopsy of lung done 22/12/16- Lung, biopsy, right middle lobe, cryobiopsy — Granulomatous inflammation.Patient has been on Prednisolone for 18 months but has no improvement and her lung function test is deteriorating.


HRCT Thorax

Findings:
There are multiples nodules, predominantly in perilymphatic distribution; are scattered in both lug fields as seen in the previous study.
No obvious dominant lung mass. No pleural effusion.
Multiple enlarged mediastinal lymph nodes (Station 1, 2R, 2L, 5, 6 ) , largest at station 6 measuring 2.5 x 1.5 cm. No hilar lymph node.
Heart size is normal. No pericardial effusion.
Bilateral axillary and visualized cervical regions lymphadenpathy as previously seen.

Large left thyroid nodule seen measuring 2.3 cm x 2.2 cm.
The visualized liver, spleen, both adrenal glands and kidneys are normal within this plain study.
No susupicious bony lesion.

Impression:
1. Case of Stage III pulmonary sarcoidosis. Current study shows no interval change
2. Left thyroid nodule.

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