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 

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.                                       

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

Case courtesy of Dr Azril