Radiographic honeycombing in pulmonary sarcoidosis

Abstract

A 65-year-old female with sarcoidosis diagnosed 17 years prior was referred for parenchymal lung changes on computed tomography (CT) chest imaging. Initial imaging demonstrated mediastinal and bilateral hilar lymphadenopathy with reticulonodular opacities, predominantly in the upper/mid lung zones, but also involving the bases. An updated CT chest from 2020 revealed new basilar honeycombing and bronchiectasis. Although it is not a common radiographic presentation, honeycombing can develop in pulmonary sarcoidosis. Whether or not honeycombing results from a progression of nodular sarcoidosis to end-stage fibrosis or represents the coexistence of two radiographic patterns is unclear. We present a case of sarcoidosis that highlights the evolution of typical reticulonodular findings of sarcoidosis to honeycombing.

Keywords:

• Sarcoidosis
• pulmonary fibrosis
• honeycombing
• stage IV

Declaration of interests

The authors have no conflicts of interest to disclose.