Diagnosis and Treatment

The findings are most consistent with sarcoidosis due to having hilar lymph node and parenchymal involvement.  The typical sarcoidosis patient is African-American and in the 2^nd to 4^th decades of life so this patient is atypical based on demographics although classic from a radiographic standpoint.

While some patients choose to use corticosteroids for treatment, this patient did not seek medical intervention.  Although the calcified lymph nodes remained, the patient’s symptoms abated after a year.  The patient was a high school chemistry teacher in a poorly ventilated building.  The chemistry lab was renovated that year and the symptoms resolved and thus may be related.  Unfortunately, sarcoidosis has an unknown etiology, although thought to be a problem of immune system regulation, and thus, we can correlate the renovation with the resolution but can’t determine if it is causal.

Regardless, the patient was able to live symptom free and return to normal activities of daily living.

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