Sarcoidosis Stage I — RACP Adult Medicine MCQ

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EasyRespiratorySarcoidosis Stage IRACP Adult Medicine

A 30-year-old woman presents with bilateral symmetrical hilar lymphadenopathy on CXR. She is asymptomatic with no respiratory symptoms. ACE level is mildly elevated. Calcium is normal. What is the most likely CXR diagnosis?

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Correct answer: A — Sarcoidosis (Stage I)

Bilateral symmetrical hilar lymphadenopathy (BHL) in an asymptomatic young woman with elevated ACE is the classic presentation of sarcoidosis Stage I. Stage I sarcoidosis (BHL alone) has >60% spontaneous remission rate. No treatment is needed unless symptomatic or organ involvement develops. Tissue biopsy showing non-caseating granulomata confirms diagnosis.

Reference: BTS – 2020 – Sarcoidosis Guidelines; eTG Respiratory 2024