Hepatic and Splenic Sarcoidosis Evaluated by Multiple Imaging Modalities.

Kataoka, Masao; Nakata, Yasunari; Hiramatsu, Junichi; Okazaki, Kazunori; Fujimori, Yosiaki; Ueno, Yoshiki; Tanimoto, Yasushi; Kanehiro, Arihiko; Tada, Shinya; Harada, Mine

doi:10.2169/internalmedicine.37.449

Cited by 30 publications

(27 citation statements)

References 17 publications

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“…20 In our patient, multiple nodular lesions, measuring 5 to 10 mm in diameter, were detected in the liver and spleen by CT and MRI. The capacities and limitations of the various imaging modalities to detect the sarcoid granulomas in our patients seem to be comparable to those in previous reports, although case reports of splenohepatic sarcoidosis detectable by MRI are limited, [21][22][23] and the authors of these reports have suggested that, on MRI, hepatic sarcoidosis is more difficult to detect than splenic lesions. [21][22][23] To summarize, we assumed that our patient had developed liver cirrhosis caused mainly by hepatic sarcoidosis, rather than by chronic hepatitis C, based on the following findings.…”

Section: Discussionsupporting

confidence: 87%

Hepatic sarcoidosis associated with chronic hepatitis C

Yamada

Mine

Fujisaki

et al. 2002

Journal of Gastroenterology

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A 57-year-old woman with sarcoidosis was referred because of the appearance of multiple small low-attenuation areas in the liver on computed tomography (CT). A liver biopsy specimen showed chronic active hepatitis accompanied by sarcoid granulomas. The patient received prednisolone and, later, interferon-alpha. CT at 5 months of prednisolone treatment showed disappearance of the hepatic low-attenuation nodules. During long-term follow-up, however, these nodules reappeared on CT and liver cirrhosis finally developed. We present this case for two reasons: (1) hepatic sarcoidosis was associated with chronic active hepatitis C; (2) hepatic nodular lesions were evaluated by CT throughout the entire course, with CT scans having been taken from 2 years prior to their appearance.

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Section: Discussionsupporting

confidence: 87%

Hepatic sarcoidosis associated with chronic hepatitis C

Yamada

Mine

Fujisaki

et al. 2002

Journal of Gastroenterology

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“…The organ is usually homogeneous, but multiple low-attenuating nodular lesions are occasionally noted and easily mistaken for lymphoma, metastases or infections [13,15,19]. Isolated or predominant hepatic nodular disease is less common than spleen impairement [2,5,13]. Besides spleen involvement, our patient presented also a hepatic nodule.…”

Section: Discussionmentioning

confidence: 65%

“…The diagnosis of sarcoidosis could be more complicated especially if abdominal sarcoidosis represents the exclusive involvement without systemic disease [3,6,9]. Usually, extrapulmonary disease occurs in the context of more extensive chest disease [13,14,15] (greatest splenic dimension >14 cm) is the most common splenic manifestation [19,20]. The organ is usually homogeneous, but multiple low-attenuating nodular lesions are occasionally noted and easily mistaken for lymphoma, metastases or infections [13,15,19].…”

Section: Discussionmentioning

confidence: 99%

“…Usually, extrapulmonary disease occurs in the context of more extensive chest disease [13,14,15] (greatest splenic dimension >14 cm) is the most common splenic manifestation [19,20]. The organ is usually homogeneous, but multiple low-attenuating nodular lesions are occasionally noted and easily mistaken for lymphoma, metastases or infections [13,15,19]. Isolated or predominant hepatic nodular disease is less common than spleen impairement [2,5,13].…”

Section: Discussionmentioning

confidence: 99%

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Unusual Presentation Of Sarcoidosis: Case Report

Tatiana

Mazilu

Crăciun

et al. 2017

ARS Medica Tomitana

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Sarcoidosis is a multisystem granulomatous disease with polymorphic manifestations, of unknown etiology, that can affect any organ in the body, but most commonly the lungs [1,2,3]. Extrapulmonary involvement is common, can occur in association with or in the absence of intrathoracic disease, and all organs can be involved, but it is rare to find an isolated extrapulmonary disease (less than 10% of patients) [3,4]. On occasion, the presentation of sarcoidosis may be atypical. We report a case of systemic sarcoidosis, with particular clinical data: extrathoracic onset with subdiaphragmatic lymph nodes, hepatomegaly and splenomegaly. Personal history and family history were insignificant.The onset was insidious, with two months prior this admission, with progressive weakness to which weight loss (10 kg) and nonspecific upper abdominal pain were associated later.His physical examination revealed only hepatomegaly and splenomegaly.Laboratory studies indicated biological inflammatory syndrome (ESR, slightly elevated fibrinogen), hypergammaglobulinemia and a negative tuberculin purified protein derivative (PPD ) skin test.Abdominal ultrasound and CT scan documented multiple subdiaphragmatic lymph nodes (periaortic, inter-aorto-caval and iliac), with diameter from 1.75 to 2.5 cm (Figure 1).

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“…La TDM révèle les lésions hépatiques dans 5% des cas et celles de la rate dans 15% des cas [24] ; l'IRM est plus performante surtout pour les lésions spléniques [25].…”

Section: Discussionunclassified

Atteinte hépatosplénique symptomatique révélatrice d’une sarcoïdose systémique

Bouomrani

Baïli

Nouma

et al. 2015

J Afr Hepato Gastroenterol

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Les localisations hépatospléniques symptomatiques inaugurales de sarcoïdose sont exceptionnelles. Nous rapportons l'observation d'une patiente de 47 ans, non tarée qui fut admise pour bilan étiologique d'un ictère cutanéo-muqueux d'aggravation progressive associé à un prurit géné-ralisé et évoluant depuis un mois. L'examen physique trouvait en plus de l'ictère cutanéo-muqueux franc, une hépato-splénomégalie ferme, irrégulière et indolore. La biologie montrait une cholestase et une cytolyse hépatique modérée sans signes d'insuffisance hépatocellulaire. L'imagerie médicale notait une hépato-splénomégalie hétérogène sans lésions focales ni adénopathies profondes associées. La biopsie hépatique montrait une hépatite granulomateuse non nécrosante et le bilan étiologique de cette granulomatose concluait à une sarcoïdose. Sous corticothérapie systémique l'évolution était favorable cliniquement, biologiquement et radiologiquement.Une meilleure connaissance de ces localisations ainsi que leur détection précoce se trouvent justifiées car influencent la stratégie thérapeutique et conditionnent le pronostic de cette granulomatose.Mots clés Sarcoïdose · Hépato-splénomégalie · Granulomatose · Imagerie · Cholestase Abstract Inaugural symptomatic hepatosplenic locations of sarcoidosis are exceptional. We report the case of a 47 years old patient without medical history who was explored for progressive worsening mucocutaneous jaundice, associated with generalized pruritus, and lasting for one month. Physical examination revealed mucocutaneous jaundice associated to an irregular and painless hepatosplenomegaly. Biology showed cholestasis and moderate hepatic cytolysis without signs of liver failure. Medical imaging noted heterogeneous hepatosplenomegaly without focal lesions or deep lymph nodes. Liver biopsy showed necrotizing granulomatous hepatitis and etiological investigation for this granulomatosis concluded to systemic sarcoidosis. Under corticosteroids the evolution was favorable clinically, biologically and radiologically.A better understanding of these locations as well as their early detection are justified because they influence the therapeutic strategy and determine the prognosis of this granulomatosis.

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Hepatic and Splenic Sarcoidosis Evaluated by Multiple Imaging Modalities.

Cited by 30 publications

References 17 publications

Hepatic sarcoidosis associated with chronic hepatitis C

Hepatic sarcoidosis associated with chronic hepatitis C

Unusual Presentation Of Sarcoidosis: Case Report

Atteinte hépatosplénique symptomatique révélatrice d’une sarcoïdose systémique

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