BMJ Case Reports 2016; doi:10.1136/bcr-2016-218187

Pulmonary sarcoidosis: calcification within the galaxy sign

  1. Ashok Shah
  1. Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
  1. Correspondence to Professor Ashok Shah, ashokshah99{at}
  • Accepted 1 December 2016
  • Published 15 December 2016


A 34-year-old woman had breathlessness, dry cough and low-grade fever for 6 months. Chest X-ray showed bilateral hilar lymphadenopathy and patchy alveolar right mid-zone shadows along with bilateral lower zone nodular opacities (figure 1A). Contrast-enhanced high-resolution CT(HRCT) of thorax demonstrated enlarged, non-necrotic right paratracheal, subcarinal and bilateral hilar lymph nodes. The lung window in right upper lobe revealed a large nodule with irregular margins encircled by multiple small nodules suggestive of ‘galaxy’ sign (figure 1B). In addition, mediastinal window divulged dense calcification within the nodule and mediastinal lymphnodes (figure 1C). Fibreoptic bronchoscopy visualised multiple endobronchial granulomatous lesions throughout the tracheobronchial tree (figure …

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