Jud W. Gurney, MD, FACR

Axial CECT shows peribronchial nodules image and subpleural nodules image in a pattern identical to sarcoidosis.

Coronal CECT shows peribronchial nodules image mainly in the right mid and lower lung. No adenopathy is present in this patient with berylliosis.


Abbreviations and Synonyms

  • Acute berylliosis, chronic berylliosis, Salem sarcoidosis


  • Beryllium: Strong lightweight element with high melting point, used in alloys in wide variety of industries

    • Inhalation causes 2 pulmonary syndromes: Acute chemical pneumonitis and chronic granulomatous lung disease


General Features

  • Best diagnostic clue

    • Pattern identical to sarcoidosis; however

      • Ground-glass opacities more common

      • Lymphadenopathy not as prominent

  • Patient position/location: Primarily mid lung with tendency to upper lobe fibrosis with chronic disease

CT Findings

  • Normal in up to 25% with proven disease

  • Morphology

    • Identical pattern to sarcoid

      • Ground-glass opacities more common

    • Nodules (65%) > ground-glass opacities (55%) > septal lines (50%)

    • Nodules may aggregate into progressive massive fibrosis (PMF) (5%)

    • Nodules may calcify

    • Upper zonal pleural thickening due to pseudoplaques (aggregation of subpleural nodules)

  • Distribution

    • Nodules lie along bronchovascular bundles, peripheral septa, subpleural lung, and fissures (50%)

    • Honeycombing in advanced disease (5%), typically worse in upper lung zones

  • Evolution

    • Successful treatment

      • Ground-glass opacities either resolve over 3 months or

      • Replaced by microcysts or septal lines

  • Other

    • Hilar or mediastinal adenopathy (40%), always associated with lung disease

      • Nodes: May have diffuse or eggshell calcification

      • Intense calcification in 10%

Radiographic Findings

Sep 20, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on Berylliosis

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