"Reversed halo sign" of high-resolution computed tomography in pulmonary sarcoidosis

Abstract

We present a case of pulmonary sarcoidosis showing the "reversed halo sign" on high-resolution computed tomography (HRCT). A 27-year-old man presented with nonproductive cough and high fever lasting for 3 weeks. A chest radiograph showed multiple areas of consolidation and cavitary shadows in the lungs. The HRCT showed the reversed halo sign, a central ground-glass opacity surrounded by crescent or ring-shaped areas of consolidation. Moreover, miliary nodules were observed in the central ground-glass opacity areas and around the outer areas of consolidation. The HRCT also showed a large nodule, subpleural nodules bordering the costal pleural surfaces, and interlobular fissure. Transbronchial biopsy was performed, and the histopathologic features were those of sarcoidosis and without cryptogenic organizing pneumonia.