Hepatosplenic Sarcoidosis: Contrast-Enhanced Ultrasound Findings and Implications for Clinical Practice

Tana, Claudio; Dietrich, Christoph F.; Schiavone, Cosima

doi:10.1155/2014/926203

Cited by 39 publications

(43 citation statements)

References 68 publications

(95 reference statements)

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“…Chest X-rays and abdominal ultrasound are useful to reveal and classify the organ involvement, but procedures such as highresolution computed tomography (HRCT), contrastenhanced magnetic resonance imaging (CEMRI), and positron emission tomography with fluorodeoxyglucose (FDG-PET) have higher sensitivity to document the degree of the involvement and are preferred in most cases (79)(80)(81). Recently, contrast-enhanced ultrasound (CEUS) has demonstrated a great potential in the diagnosis and assessment of the disease, also in the cases in which non-enhanced ultrasound is traditionally not significant (82)(83)(84)(85).…”

Section: The Role Of Imagingmentioning

confidence: 99%

Challenges in the diagnosis and treatment of neurosarcoidosis

et al. 2015

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The diagnosis and treatment of neurosarcoidosis can be very challenging for several reasons. It affects clinically 5%-10% of sarcoidosis patients, but can be found in up to 25% of autopsies. These data reveal that a high percentage of asymptomatic or misdiagnosed cases can be missed at an initial diagnostic approach. Clinical and imaging findings are often non-specific since they can be found in a large number of neurological disorders. Histopathology can also be confounding if not performed by an expert pathologist and not placed in an appropriate clinical context. In this review, we discuss clinical features, laboratory findings, imaging, and histology of neurosarcoidosis, and we report current evidence regarding drug therapy. We conclude that a correct diagnostic approach should include a multidisciplinary evaluation involving clinicians, radiologists, and pathologists and that future studies should evaluate the genetic signature of neurosarcoidosis as they could be helpful in the assessment of this uncommon disease. With head-to-head comparisons of medical treatment for neurosarcoidosis still lacking due to the rarity of the disease and an increasing number of immunomodulating therapies at hand, novel therapeutic approaches are to be expected within the next few years. Key messages Neurosarcoidosis is a rare disorder that affects clinically 5%-10% of sarcoidosis patients, but can be found in up to 25% of autopsies, revealing that a high percentage of asymptomatic or misdiagnosed cases can be missed at an initial diagnostic approach. A multidisciplinary evaluation is useful to achieve a correct diagnosis because clinical and imaging findings are often non-specific. Corticosteroids are the first-line treatment for neurosarcoidosis, followed by steroid-sparing immune-modulating agents if prednisone therapy is insufficient. Dear Author, Please check these proofs carefully. It is the responsibility of the corresponding author to check against the original manuscript and approve or amend these proofs. A second proof is not normally provided. Informa Healthcare cannot be held responsible for uncorrected errors, even if introduced during the composition process. The journal reserves the right to charge for excessive author alterations, or for changes requested after the proofing stage has concluded.The following queries have arisen during the editing of your manuscript and are marked in the margins of the proofs. Unless advised otherwise, submit all corrections using the CATS online correction form. Once you have added all your corrections, please ensure you press the ''Submit All Corrections'' button.Please review the table of contributors below and confirm that the first and last names are structured correctly and that the authors are listed in the correct order of contribution. The diagnosis and treatment of neurosarcoidosis can be very challenging for several reasons. It affects clinically 5%-10% of sarcoidosis patients, but can be found in up to 25% of autopsies. These data reveal that a high percenta...

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Section: The Role Of Imagingmentioning

confidence: 99%

Challenges in the diagnosis and treatment of neurosarcoidosis

et al. 2015

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“…Other concomitant etiologies can indeed occur such as nonalcoholic fatty liver disease and viral hepatitis and differential diagnosis can be challenging if a high clinical suspect does not occur in these situations [7,8].…”

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“…Other common findings are splenomegaly, with or without prominent nodules and lymph node enlargement [7,[9][10][11]. Overcoming common limits of traditional contrast-imaging techniques, contrast-enhanced ultrasound (CEUS), a novel safe US technique, has documented reliability to detect nodules in some case series, where conventional US was usually negative [8,12,13].…”

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Multiple Facets of Abdominal Sarcoidosis

Tana¹,

Tana²,

Carlo³

et al. 2016

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“…However, even though the role of conventional imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) has been described widely in the literature [9], there is a lack of information regarding the use of contrast-enhanced ultrasound (CEUS) [6]. No studies have been designed in patients with sarcoidosis and current data is limited on the description of small cases series; however, we have found recently that CEUS has a great potential in the assessment of focal lesions in sarcoidosis, in particular those affecting liver and spleen [10]. Hypo and hyperechoic lesions but also isoechoic masses can be clearly highlighted after injecting contrast agent.…”

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confidence: 99%

“…Hyperecoic nodules, both in liver and spleen, are even rarer and no CEUS pattern has been reported so far in the literature; however, we expect similar features between hypo and hyperechoic nodules in view of their similar hypodense pattern on CECT. Isoechoic lesions, that are not evident on conventional B-mode US, can be easily revealed after injecting contrast agent [10]. The different aspect on imaging has already been attributed to a different degree of fibrous tissue in the lesions [11,12].…”

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confidence: 99%