A New Variant of “Sarcoid Cluster Sign”….But in Tuberculosis

A 29-year-old Caucasian woman on post-partum was affected by fever, right lower quadrant abdominal pain, irregular alvus and lung micronodules at chest X-ray. Thoracic and abdominal MDCT imaging investigations accompanied by microbiological tests of bronchial aspirate, histology on the surgical bowel specimen resulted positive for pulmonary and intestinal tuberculosis (TB). Volumetric high-resolution computed tomography (HRCT) demonstrated a very interesting pattern about nodules distribution called “Sarcoid cluster sign” (Fig. A). Coronal (Fig. B) and sagittal (Fig. C) Maximum Intensity Projection (MIP) images (18-mm-thick slab) demonstrate the micronodules clusters distribution prevalent in the upper lobes.