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British Journal of Radiology (2004) 77, 1042-1045
© 2004 British Institute of Radiology
doi: 10.1259/bjr/29049682

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The CT halo: a new sign in active pulmonary sarcoidosis

K Marten, MD E J Rummeny, MD and C Engelke, MD

Department of Radiology, Klinikum rechts der Isar der TU München, Ismaningerstr. 22, 81675 München, Germany



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Figure 1. 30-year-old woman with pulmonary nodular and cardiac sarcoidosis. (a) Chest CT at the time of diagnosis displaying a 3 cm right upper lobe mass. Adjacent sections show that the pulmonary nodule is composed of innumerable coalescing micronodules (arrowheads), referred to as the "sarcoid galaxy sign" (b, c). This lesion was chosen for transthoracic biopsy. Follow-up CT scans after first course of steroid therapy 2 months later (d), showing size reduction of the nodule and no evidence of ground glass opacitiy. After 5 months, there occurred a large perifocal ground glass halo with relapsing clinical disease activity (e) and final follow-up 6 months after termination of second course of steroid therapy displaying a residual scar-like shaped density without any ground glass attenuation (f). Initial and follow-up CT scans showing the evolution of lingular, middle lobe and right lower lobe angiocentric nodules before therapy (g, arrowheads), their residua after first steroid therapy course with 60 mg day–1 prednisolone 2 months later (h, arrowheads), ground glass halos with relapsing sarcoid activity after steroid dose reduction to 10 mg day–1 prednisolone after 5 months (i, arrows) and final resolution and minimal scar-like residua 6 months after termination of second steroid course (j, arrowheads). Note that the ground glass halos have completely resolved.

 





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