PMC4586909_01
The control chest x-ray before anti-TNF treatment (March 2010).
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There was no sign of infiltration in the chest x-ray (Figure 1), and the lung examination was normal.
The chest x-ray during anti-TNF treatment (August 2012).
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August 2012. At that date, bilateral hilar swelling and a reticulonodular appearance at the bilateral middle and lower zones were detected during bilateral chest x-ray (Figure 2).
Bilateral millimetric nodules and interstitial thickening in peribrochovascular areas of upper zones are shown.
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High-resolution CT revealed peribronchovascular nodules in the bilateral upper and middle zones that were centrally located (Figures 3-5); hilar and mediastinal lymphadenopathies were also detected (Figures 6 and 7).
Parenchymal window showing widespread millimetric nodules and interlobular thickening in peribrochovascular and subpleural areas of bilateral upper zones.
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High-resolution CT revealed peribronchovascular nodules in the bilateral upper and middle zones that were centrally located (Figures 3-5); hilar and mediastinal lymphadenopathies were also detected (Figures 6 and 7).
Parenchymal window showing unaffected areas in bilateral lower lobes.
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High-resolution CT revealed peribronchovascular nodules in the bilateral upper and middle zones that were centrally located (Figures 3-5); hilar and mediastinal lymphadenopathies were also detected (Figures 6 and 7).
Mediastinal window showing lymph nodes in stations 4R, 5, and 6.
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High-resolution CT revealed peribronchovascular nodules in the bilateral upper and middle zones that were centrally located (Figures 3-5); hilar and mediastinal lymphadenopathies were also detected (Figures 6 and 7).
Mediastinal window showing lymph nodes in stations 10R and 10L.
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High-resolution CT revealed peribronchovascular nodules in the bilateral upper and middle zones that were centrally located (Figures 3-5); hilar and mediastinal lymphadenopathies were also detected (Figures 6 and 7).
Control thorax HRCT parenchymal window showing regression of nodules and interstitial thickening in bilateral upper zones.
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Thereafter, we observed regression in the control chest x-ray and high-resolution CT (Figures 8-11), and the patient is now on topical treatment for psoriasis without any treatment for sarcoidosis.
Control thorax HRCT parenchymal window showing regression of nodules and interstitial shadows.
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Thereafter, we observed regression in the control chest x-ray and high-resolution CT (Figures 8-11), and the patient is now on topical treatment for psoriasis without any treatment for sarcoidosis.
Control thorax HRCT with mediastinal window showing regression in the size of mediastinal lymph nodes.
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Thereafter, we observed regression in the control chest x-ray and high-resolution CT (Figures 8-11), and the patient is now on topical treatment for psoriasis without any treatment for sarcoidosis.
Control thorax HRCT with mediastinal window showing disappearance of hilar lymph nodes.
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Thereafter, we observed regression in the control chest x-ray and high-resolution CT (Figures 8-11), and the patient is now on topical treatment for psoriasis without any treatment for sarcoidosis.