PANCE Pulmonology Practice Test

In sarcoidosis, which radiographic finding is NOT typical?

Bilateral hilar lymphadenopathy Reticulonodular markings Cavitary lesions Noncaseating granulomas (histology)

Correct Answer:

Noncaseating granulomas (histology)

Explanation:

The key idea is that chest imaging in sarcoidosis typically shows signs of lymph node involvement and interstitial lung changes—not tissue-level histology. On radiographs, you’d expect bilateral hilar lymphadenopathy and a reticulonodular pattern from granulomatous infiltration in the lungs. Cavitary lesions are not a typical radiographic feature of sarcoidosis, and when present they raise other possibilities. The histologic hallmark of sarcoidosis is noncaseating granulomas, which are a tissue finding seen on biopsy, not something seen on a chest X-ray. Because the question asks for a radiographic finding, the noncaseating granulomas described histologically are not a radiographic feature, making that option the correct choice.

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