Gastric sarcoidosis

Abstract

Sarcoidosis of the gastrointestinal tract is uncommon even though involvement of the liver, spleen, and adenopathy are becoming recognizable entities on computed tomography (CT). Involvement of the stomach, the most common site of sarcoidosis of the gastrointestinal tract, is usually associated with pulmonary disease. The radiologic appearances of gastric involvement are variable. Positive biopsies may be obtained in a radiologically normal stomach. Ulceration resembling peptic ulcer disease may occur, and mucosal enlargement may be minor, diffusely nodular, or significant enough to mimic Menetrier disease. In its most dramatic form, a linitis plastica appearance resembling scirrhous carcinoma has been reported.

Imaging Manifestations of Abdominal Sarcoidosis

“…Plaquelike lesions have been reported in the esophagus [45]. Gastric sarcoidosis may present as mucosal nodularity and thickened irregular folds, radiographic features that may be indistinguishable from those of Ménétrier's disease [45,49] (Fig. 11).…”

“…11). Apthous ulcers and larger ulcerations have been seen as well as linear and polypoid filling defects in the stomach [49] (Fig. 12).…”

Radiologic Manifestations of Sarcoidosis in Various Organs

“…The stomach is the most common site of involvement, although sarcoidosis has been reported in every part of the gastrointestinal tract (30). Gastric sarcoidosis has a predilection for the antrum.…”

Gastrointestinal Sarcoidosis and Gastric Melanosis (Video)

“…Conversely, GI tract involvement is rare. Granulomatous inflammation may be seen in the (1) mucosa and submucosal layers, leading to erosion, ulceration, polypoid or mass lesion, and stricture; (2) nerves, leading to dysmotility and/or secondary achalasia; and (3) muscles; also causing dysmotility [5][6][7][8][9][10][11][12][13][14][15][16]. Clinical features of sarcoidosis include extrinsic GI tract compression due to lymphadenopathy, pancreatic involvement presenting as a mass lesion or diffuse enlargement, esophageal involvement with secondary achalasia, dysmotility, and pseudodiverticulosis, the stomach, especially the antrum, is the most common luminal GI organ to be involved in sarcoidosis, the small bowel is the least commonly involved, if the colon is involved, pathological findings are most often in the sigmoid colon and GI involvement may cause non-specific presenting symptoms: nausea, vomiting, weight loss, GI bleeding, abdominal pain, obstructive symptoms, protein losing enteropathy, malabsorption, diarrhea, etc.…”