Medical image of the week: sarcoidosis

No abstract available. Article truncated after 150 words. We present a 58-year-old African American man with a complicated medical history including long-standing sarcoidosis that has caused him chronic, unrelenting pain for two decades. He initially underwent placement of an intrathecal morphine pump, but recently began complaining of increasing pain. Consequently, he was seen at our hospital for interrogation of his pain pump by the interventional radiologist, and was incidentally noted to have bilateral calcified hilar lymphadenopathy on fluoroscopic imaging. A dedicated chest x-ray confirmed the abnormality, which was consistent with his known diagnosis of sarcoidosis. Sarcoidosis is a complex disease process characterized by noncaseous granulomas that can affect various organ systems, with pulmonary involvement in up to 90% of cases (1). Though sarcoidosis is a diagnosis of exclusion, clinicians should recognize that bilateral hilar lymphadenopathy is highly concerning for the underlying noncaseating granulomatous disease (2). The most common pattern of lymphadenopathy is well-defined, bilateral, symmetric hilar and right ..