In sarcoidosis, which radiographic finding is NOT typical?

• A. Bilateral hilar lymphadenopathy
• B. Reticulonodular markings
• C. Cavitary lesions
• D. Noncaseating granulomas (histology)

Answer: (D)

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.