Chest and cardiac imaging: galaxy sign in sarcoidosis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest and cardiac imaging: galaxy sign in sarcoidosis

Sample item

A CT shows a larger nodule surrounded by many tiny satellite nodules along the bronchovascular bundles and subpleural regions, with symmetric hilar nodes. Which condition is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Sarcoidosis

A cluster of small perilymphatic nodules around a larger nodule, the galaxy sign, with symmetric hilar nodes is characteristic of sarcoidosis. Miliary tuberculosis gives random nodules, lymphangitic spread causes septal thickening, and hypersensitivity pneumonitis shows centrilobular ground glass and air trapping.

Option by option

  • A. Lymphangitic carcinomatosis

    Lymphangitic carcinomatosis shows beaded septal thickening.

  • B. Miliary tuberculosis

    Miliary tuberculosis has uniform random nodules without a cluster pattern.

  • C. Sarcoidosis (correct)

    Correct. A galaxy pattern with symmetric hilar nodes indicates sarcoidosis.

  • D. Hypersensitivity pneumonitis

    Hypersensitivity pneumonitis shows poorly defined centrilobular nodules and mosaic attenuation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Sarcoidosis. A cluster of small perilymphatic nodules around a larger nodule, the galaxy sign, with symmetric hilar nodes is characteristic of sarcoidosis.

Why is "Lymphangitic carcinomatosis" not the answer?

Lymphangitic carcinomatosis shows beaded septal thickening.

Why is "Miliary tuberculosis" not the answer?

Miliary tuberculosis has uniform random nodules without a cluster pattern.

Why is "Hypersensitivity pneumonitis" not the answer?

Hypersensitivity pneumonitis shows poorly defined centrilobular nodules and mosaic attenuation.

What concept does this question test?

It tests Chest and cardiac imaging: galaxy sign in sarcoidosis in Radiology. Miliary tuberculosis gives random nodules, lymphangitic spread causes septal thickening, and hypersensitivity pneumonitis shows centrilobular ground glass and air trapping.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest and cardiac imaging: galaxy sign in sarcoidosis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.