Nodular sarcoidosis of the liver and spleen: analysis of 32 cases.

Warshauer, David M.; Molina, Paul L.; Hamman, S M; Koehler, R E; Paulson, Eric K.; Bechtold, Robert E.; Perlmutter, M L; Hiken, James N.; Francis, Isaac R.; Cooper, Cirrelda

doi:10.1148/radiology.195.3.7754007

Cited by 125 publications

(101 citation statements)

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“…Hepatomegaly is the most common imaging finding of hepatic sarcoidosis, detected on computed tomography (CT) of the abdomen in about more than half of the patients (9). It is often associated with splenomegaly.…”

Section: Liver and Biliary Tractmentioning

confidence: 99%

Abdominal sarcoidosis: cross-sectional imaging findings

Gezer¹,

Başara²,

Altay³

et al. 2015

Diagn Interv Radiol

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Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%-70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis.

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Section: Liver and Biliary Tractmentioning

confidence: 99%

Abdominal sarcoidosis: cross-sectional imaging findings

Gezer¹,

Başara²,

Altay³

et al. 2015

Diagn Interv Radiol

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“…12 Approximate lesion size in hepatosplenic involvement aids diagnosis. A relatively small lesion may suggest sarcoidosis, 12 and when sarcoidosis involves the liver and spleen, splenic nodules are usually larger than hepatic lesions (Fig. 1A).…”

Section: Hepatosplenic Sarcoidosismentioning

confidence: 99%

“…1A). 12,13 Sarcoid nodules show hyper-or hypointensity on T 2 -and diŠusion-weighted images (Fig. 1).…”

Section: Hepatosplenic Sarcoidosismentioning

confidence: 99%

Hepatosplenic and Muscular Sarcoidosis: Characterization with MR Imaging

Sekine¹,

Amano²,

Hidaka³

et al. 2012

MRMS

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Sarcoidosis is a multisystem disorder of unknown etiology that involves multiple organs. Computed tomography is theˆrst-line imaging modality for diagnosing sarcoidosis because of its capacity to detect hilar lymphadenopathy and pulmonary lesions. Magnetic resonance (MR) imaging provides good soft tissue contrast that is useful for detecting sarcoidosis in some body parts, including skeletal muscle. Signal intensity on pre-and postcontrast T 1 -and T 2 -weighted imaging may re‰ect disease activity and the pathological appearance of sarcoidosis. In this review, we demonstrate these conventional MR imaginĝ ndings of hepatosplenic and muscular sarcoidosis and describe the usefulness of diŠusion-weighted imaging for detecting sarcoidosis.

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“…5 Hepatomegaly is found in about 21-50% of the patients. [6][7][8] Liver involvement may occur without lung involvement in up to 47% of the patients. 9 Abnormal liver chemistries are noted in only 35% of patients.…”

mentioning

confidence: 99%

Long-Term Outcomes of Liver Transplantation for Hepatic Sarcoidosis: A Single Center Experience

Bilal

Ismail

Vanatta

2016

Journal of Clinical and Experimental Hepatology

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Aim: Hepatic sarcoidosis is a rare indication for orthotopic liver transplantation (OLT). Hence, studies evaluating these patients are scarce. We present a single center experience with OLT for hepatic sarcoidosis in a case-control study. Methods: A retrospective chart review was performed on 970 patients with OLT at our center, and 13 patients (1.3%) were identified who underwent 14 OLTs for hepatic sarcoidosis. For each case, two controls matched for etiology of liver disease, recipient age (AE5 years), and duration since transplant (within 5 years) were selected. Results: For the 13 patients transplanted for sarcoidosis, the median age was 46 years. The majority were women (62%) and African-American (85%). Cholestatic liver disease was the primary manifestation. Portal hypertensive complications were present in 11 patients (84%). The median MELD score at transplantation was 19. Extra-hepatic manifestations were present in ten patients (77%). All patients received whole deceased 14 donor allografts. Six patients remain alive with a median post-OLT follow-up of 8.4 years. The 1-, 3-, 5-, and 10-year patient survival rates were 84.6%, 76.9%, 61.1%, and 51.3%, respectively for the sarcoidosis group and 82.1%, 78.6%, 78.6%, and 61.9%, respectively for the matched PSC/PBC group (P = 0.739). Re-graft free survival for sarcoidosis patients was 84.6%, 76.9%, 61.5%, and 51.3% for 1-, 3-, 5-, and 10-years and for the matched control group re-graft free survival was 78.6% at 1-, 3-, 5-years, and 64.8% at 10-years (P = 0.661). Recurrence of hepatic sarcoidosis was found in 4 patients at 11 days, 112 days, 222 days, and 6.6 years. Conclusions: Our study depicts the long-term benefit of liver transplantation in patients with end stage liver disease secondary to sarcoidosis. It shows statistically comparable graft and patient survival for such patients when compared to other cholestatic diseases. Disease recurrence, although possible, has not been shown to cause allograft dysfunction. ( J CLIN EXP HEPATOL 2016;6:94-99)

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Nodular sarcoidosis of the liver and spleen: analysis of 32 cases.

Abstract: Nodular hepatosplenic sarcoidosis is associated with organomegaly, adenopathy, and symptoms. Nodules were not associated with advanced lung disease and did not herald a change in chest radiographic stage. An elevated ACE level may be helpful in diagnosis.

Cited by 125 publications

References 0 publications

Abdominal sarcoidosis: cross-sectional imaging findings

Abdominal sarcoidosis: cross-sectional imaging findings

Hepatosplenic and Muscular Sarcoidosis: Characterization with MR Imaging

Long-Term Outcomes of Liver Transplantation for Hepatic Sarcoidosis: A Single Center Experience

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