Upper lobe collapse due to endobronchial sarcoidosis.

Endoluminal Stenosis of Proximal Bronchi in Sarcoidosis

“…This is often associated with a thickened and inflamed mucosa. 27 These two mechanisms are not mutually exclusive and can occur simultaneously. 4 A third mechanism reported is the development of an endobronchial mass lesion, which remains anecdotal.…”

Radiographic and Histopathologic Features in Sarcoidosis: A Pictorial Display

“…Lobar atelectasis has been described in patients with sarcoidosis due to extrinsic compression of lymph nodes 46,54,55 or endobronchial involvement, 51,[56][57][58][59] , but is rare. The right middle lobe is most often affected due to its small orifice, sharp angulation from the bronchus intermedius, and large number of local lymph nodes.…”

Airways Disease in Sarcoidosis

“…[51,52] Atelectasis of the middle lobe is most common but atelectasis of the right upper lobe has also been reported. [53] The middle lobe is particularly susceptible to collapse because it has a small bronchial lumen, surrounded by many lymph nodes and emerges at a right angle from the bronchus intermedius. Collapse of the right upper lobe may result in the radiographic S-sign of Golden, which is commonly associated with cancer.…”

“…[85] Patients with bronchostenosis respond poorly to treatment with systemic corticosteroids. [33,37,46,47,53] Fouty and associates used a flexible fiberoptic bronchoscope and a Fogarty embolectomy catheter to dilate multiple bronchial stenoses under direct vision. [86] The six patients who underwent the procedure were symptomatic and refractory to corticosteroids.…”