Imaging Manifestations of Abdominal Sarcoidosis

Warshauer, David M.; Lee, Joseph K. T.

doi:10.2214/ajr.182.1.1820015

Cited by 185 publications

(166 citation statements)

References 51 publications

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“…In our case, the FDG-PET and gallium scintigraphy examinations indicated isolated hepatic involvement. In line with previous reports concerning radiological findings, MRI showed a large number of small foci of hypointensity on both T2WI and DWI (11,12). Interestingly, the patient showed an elevated serum level of IgG4.…”

Section: Discussionsupporting

confidence: 91%

Hepatic Sarcoidosis with an Increased Serum Level of Immunoglobulin G4

et al. 2012

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A 70-year-old woman with an increased uptake of 18-Fluorodeoxyglucose (FDG) in whole liver on positron emission tomography (PET) was referred to our hospital. Laboratory examinations showed increased serum levels of total immunoglobulin G (IgG) and IgG4. Gallium scintigraphy showed a remarkable uptake in the liver but not in any other organs. On computed tomography (CT) and magnetic resonance imaging (MRI), multiple foci of abnormal density were observed in the liver, but the pancreas and bile duct lacked any indications of IgG4-related sclerosing disease. A liver biopsy specimen revealed multiple non-necrotizing granulomas. This is the first report of hepatic sarocidosis in a patient with an elevated serum level of IgG4.

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Section: Discussionsupporting

confidence: 91%

Hepatic Sarcoidosis with an Increased Serum Level of Immunoglobulin G4

et al. 2012

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“…The pulmonary parenchyma and mediastinal and hilar nodal groups are the most commonly involved sites but any organ system can be involved. Hepatic involvement is seen in 75% of the cases in sarcoidosis, spleen being involved in 40-60% of cases mainly as splenomegaly or less commonly as multiple focal splenic lesions as in our case [5]. Most commonly intra-abdominal lymphadenopathy, splenic and hepatic sarcoidosis can be asymptomatic, but can present with marked constitutional symptoms as in our patient or sometimes pressure symptoms.…”

Section: Discussionsupporting

confidence: 53%

Multidisciplinary Approach: An Essential Step in Diagnosing Granulomatous Disease

Sujanitha¹,

Kumanan²,

Selvaratnam³

et al. 2017

JCR

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Background: Abdominal lymphadenopathy is a common presentation of many diseases and sarcoidosis should be considered as an important differential diagnosis. Prompt early diagnosis would help to minimize the disease progression and its complications. Case Report: A 51 year old female presented with appetite and weight loss of seven months duration and found to have an intra-abdominal lymphadenopathy. A celiac axis lymph node biopsy showed granulomatous lymphadenitis and the patient quickly progressed to develop hepato-splenomegaly with CT evidence of multiple attenuation areas in spleen, intra-pulmonary nodules with lymphadenopathy. An endo-bronchial biopsy also confirmed a non-necrotizing granulomatous inflammation. Patient had a remarkable improvement in symptoms with oral steroids. Conclusion: Intra-abdominal lymphadenopathy, an initial presentation of many common diseases has heterogeneous etiology and sarcoidosis is one important clinical diagnosis. Appropriate use of available investigations and careful regular clinical assessment with multi-disciplinary approach to identify new organ involvement will help to arrive at early diagnosis and treatment.

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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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Imaging Manifestations of Abdominal Sarcoidosis

Cited by 185 publications

References 51 publications

Hepatic Sarcoidosis with an Increased Serum Level of Immunoglobulin G4

Hepatic Sarcoidosis with an Increased Serum Level of Immunoglobulin G4

Multidisciplinary Approach: An Essential Step in Diagnosing Granulomatous Disease

Challenges in the diagnosis and treatment of neurosarcoidosis

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