Pulmonary sarcoidosis in the older patient: conventional radiographic features

The clinical and radiographic findings in 29 patients presenting with pulmonary sarcoidosis after the age of 50 years were reviewed. Fifty-nine percent (17 patients) had atypical findings at presentation. The atypical patterns at radiography included mediastinal adenopathy alone or in combination with unilateral hilar adenopathy (n = 8), solitary or multiple pulmonary masses (n = 3), and atelectasis (n = 3). Five patients had extrathoracic tumors at the time that the diagnosis of pulmonary sarcoidosis was made, which confused the diagnosis at radiography. An enhanced awareness of the atypical patterns of sarcoidosis in the older patient may facilitate the diagnostic process.