%0 Journal Article %T Medical image of the week: sarcoidosis %A Knox KS %J Southwest Journal of Pulmonary and Critical Care %D 2013 %I Arizona Thoracic Society %X A 42 year old African-American man from Indianapolis presented with cough and skin lesions. ACE level was elevated at 86 ¦̀g/L. Spirometry was normal except for a diffusing capacity 52% of predicted. Imaging was suggestive of sarcoidosis versus granulomatous infection. Bronchoscopy with bronchoalveolar lavage cytospin revealed a lymphocytic alveolitis (27% lymphocytes) with a CD4:CD8 ratio of 6.2:1 by flow cytometry. Biopsy showed classic noncaseating granulomas and no organisms supporting the diagnosis of sarcoidosis. The patient¡¯s symptoms and radiographic findings improved with 20 mg prednisone every other day for 3 months duration. %K sarcoidosis %K bilateral hilar adenopathy %K lung granuloma %K lymphocytic alveolitis %K CD4:CD8 ratio %K noncaseating %U http://www.swjpcc.com/imaging/2013/2/20/medical-image-of-the-week-sarcoidosis.html