Correct!
4. Sarcoidosis
Chest radiography shows a unilateral lobulated, circumscribed mass in the left hilum; the right hilum and mediastinum are normal. Lucency in the left lung, particularly left upper lobe, suggests air trapping. These findings indicate a lesion arising from or involving the airway. All the choices above, except sarcoidosis, commonly involve the large airways and may present as a central hilar masses associated with bronchial obstruction. In contrast, while sarcoidosis may present with hilar enlargement due to lymphadenopathy, the hilar nodal involvement is commonly symmetric and frequently accompanied by mediastinal lymph node enlargement; the latter is not present in this case. Furthermore, sarcoidosis is rarely associated with central unilateral endobronchial obstruction.
Clinical Course: The patient subsequently underwent thoracic CT (Figures 2 and 3).
Figurer 2 (above). Axial thoracic CT scan (A-G= lung windows, H-I soft tissue windows). (click here for a movie of the axial CT scan)
Figure 3 (above). Coronal thoracic CT images (lung windows). (click here for a movie of the coronal CT scan)
Regarding the CT appearance of the lesion, which of the following is most accurate?
