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Internal Medicine

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42-year-old man with progressive cough, fever, and shortness of breath for three weeks. He recently placed mulch in his backyard.

Patient History:

  • Medical Conditions: Hyperlipidemia and hypertension.

  • Medications: Atorvastatin 20 mg daily, lisinopril 10 mg daily.

  • Lifestyle: Non-smoker.

  • Recent Activity: Recently placed mulch in his yard.


Harsh Sura
ekseibi
ekseibi
Jul 09

AIP

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Harsh Sura
Nader Guma


Symmetric diffuse, bilateral pulmonary infiltrates with mediastinal and bilateral hilar lymphadenopathy. DDx?


Harsh Sura
Nader Guma

Sarcoidosis

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Harsh Sura
Israr Khan
Nader Guma

Thank you, in addition to the pneumomediastinum and SQ emphysema, there is also a pneumothorax on the right side and a chest tube is needed since this patient is on the ventilator. @Everyone

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Determining CD4+/CD8+ ratio can be helpful in the diagnosis of sarcoidosis. Sarcoidosis is characterized by an increased CD4/CD8 ratio (>3.5), compared with other interstitial lung diseases.

Nader Guma

A 57-year-old sarcoidosis patient is showing "cobblestone" appearance in the endobronchial Biopsy proved multiple non-necrotizing granulomas.

Nader Guma
Apoorva Pandharpurkar

Löfgren syndrome is a type of acute sarcoidosis an inflammatory disorder characterized by swollen lymph nodes in the chest, tender red nodules on the shins, fever and arthritis.

Harsh Sura
Apoorva Pandharpurkar

Heerfordt syndrome, or uveoparotid fever, occurs in 10% of cases and consists of a triad of parotid enlargement, uveitis, and seventh cranial nerve palsy

Harsh Sura
Nader Guma
Apoorva Pandharpurkar

This figure shows three consecutive FDG-PET performed in a patient with progressively more aggressive therapy for sarcoidosis.

Harsh Sura
Nader Guma

Bilateral apical pneumothoraces, approximately 10% in size on the right and 20-30% on the left without mediastinal shift with diffuse alveolar infiltrates and air bronchograms.

Harsh Sura
Nader Guma

Manar  Ismail
Sabri Elmansouri
Nader Guma
Apoorva Pandharpurkar

The lung is anatomically divided into smaller units known as lobules, which are the smallest functional units of the lung visible to the naked eye. Each lobule is roughly hexagonal in shape and is bounded by connective tissue septa. Within these lobules, the lung's essential structures for gas exchange are contained, including terminal bronchioles, respiratory bronchioles, alveolar ducts, and alveoli. The terminal bronchiole, which is the smallest airway without alveoli, branches into several respiratory bronchioles, marking the transition where gas exchange begins. Blood supply to the lobules is via the pulmonary arteries and veins traveling through septa and branching along the bronchioles. Lymphatic vessels within the lobules help to maintain fluid balance and remove debris.

The "crazy paving" pattern on chest HRCT or standard CT refers to the appearance of ground-glass opacities with superimposed interlobular and intralobular septal thickening. This pattern is named for its resemblance to irregularly laid paving…