Pulmonary Sarcoidosis Presenting with Miliary Opacities

Author(s): Omar Arar*, Fabrizio Boni, Tiziana Meschi, Claudio Tana.

Journal Name: Current Medical Imaging

Volume 15 , Issue 1 , 2019

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Graphical Abstract:


Abstract:

Background: Lung lesions often appear in patients with sarcoidosis; however, miliary opacities are rare. We present the case of a 55-year-old Indian man who presented with dyspnea and low-grade fever.

Discussion: Miliary Tuberculosis (TB) was initially suspected, despite the direct microscopic examination from bronchoalveolar lavage was negative for acid-fast bacilli because imaging showed miliary opacities, and transbronchial lung biopsy revealed the presence of typical caseating granulomas. Antitubercular treatment with the classic four-drug regimen was initiated. However, the patient did not improve and cultures were negative for Mycobacterium growth. The diagnosis of sarcoidosis was made only after a negative culture and clinical and histopathological re-evaluation of the case.

Conclusion: Although miliary sarcoidosis is rare, physicians should consider sarcoidosis in the differential diagnosis with conditions like tuberculosis, malignancy, and pneumoconiosis when patients present with miliary opacities who do not respond to the traditional treatment.

Keywords: Pulmonary sarcoidosis, miliary, granuloma, tuberculosis, lung lesions, Mycobacterium.

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Article Details

VOLUME: 15
ISSUE: 1
Year: 2019
Page: [81 - 83]
Pages: 3
DOI: 10.2174/1573405614666180806141415
Price: $58

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