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September 22, 1978

Solitary Pulmonary Nodule in Sarcoidosis

JAMA. 1978;240(13):1379-1380. doi:10.1001/jama.1978.03290130073029

ROENTGENOGRAPHIC features of pulmonary sarcoidosis include bilateral symmetrical hilar adenopathy, alveolar infiltrates, chronic upperlobe fibrosis and cavitary disease, and reticular or nodular interstitial infiltrates.1 Unusual roentgenographic manifestations of this disease are giant bulla formation, multiple nodules, pleural thickening and effusion, and nonsymmetrical hilar or perihilar masses.2 The solitary pulmonary nodule is a rare manifestation of pulmonary sarcoidosis.

Report of a Case  A 32-year-old black woman was in excellent health until she lost weight, and a nonproductive cough, malaise, and lowgrade fever developed. An intermediate-strength PPD tuberculin test had been positive for approximately ten to 15 years, without a history of isoniazid prophylaxis. She smoked two packs of cigarettes per day for approximately 15 years and has a history of sickle cell trait. The patient is from the West Indies and has no history of recent travel to any area of endemic fungal disease.Her vital signs were normal,