Chest imaging: sarcoidosis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest imaging: sarcoidosis

Sample item

A young woman has a chest radiograph with symmetrical bilateral hilar enlargement and right paratracheal nodes, and is otherwise well apart from erythema nodosum. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Sarcoidosis (Lofgren syndrome)

Symmetrical bilateral hilar lymphadenopathy with erythema nodosum and arthralgia is Lofgren syndrome, a good-prognosis form of sarcoidosis. The right paratracheal node enlargement is described as a 1-2-3 sign. Unilateral or asymmetrical adenopathy would favour lymphoma or tuberculosis.

Option by option

  • A. Bronchogenic carcinoma

    Carcinoma presents with a unilateral hilar mass.

  • B. Lymphoma

    Lymphoma is usually asymmetric and with systemic symptoms.

  • C. Primary tuberculosis

    Primary TB tends to cause unilateral hilar adenopathy.

  • D. Sarcoidosis (Lofgren syndrome) (correct)

    Correct. Bilateral symmetrical hilar nodes with erythema nodosum suggest sarcoidosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Sarcoidosis (Lofgren syndrome). Symmetrical bilateral hilar lymphadenopathy with erythema nodosum and arthralgia is Lofgren syndrome, a good-prognosis form of sarcoidosis.

Why is "Bronchogenic carcinoma" not the answer?

Carcinoma presents with a unilateral hilar mass.

Why is "Lymphoma" not the answer?

Lymphoma is usually asymmetric and with systemic symptoms.

Why is "Primary tuberculosis" not the answer?

Primary TB tends to cause unilateral hilar adenopathy.

What concept does this question test?

It tests Chest imaging: sarcoidosis in Radiology. The right paratracheal node enlargement is described as a 1-2-3 sign. Unilateral or asymmetrical adenopathy would favour lymphoma or tuberculosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: sarcoidosis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.