Sarcoidosis is a systemic inflammatory disease of idiopathic etiology affecting the lungs, eyes, skin, heart, and liver, though the extent of extra thoracic involvement varies between patients.40 Up to 20% of patients with sarcoidosis develop pulmonary fibrosis, termed fibrotic sarcoidosis.40 The predominant findings are granulomas surrounded by fibroblastic foci, accompanied by a variable degree of volume loss, architectural distortion, bronchial distortion, and honeycombing. Traction bronchiectasis is often observed, and fibrosis is predominantly limited to the upper and middle lobes.40