Ultrasound imaging of abdominal sarcoidosis: State of the art

Abstract

Since it has been recognized that sarcoidosis (SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound (US) is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs ( e.g ., lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.

Hepatic Sarcoidosis: Current Concepts and Treatments

“…32 Heterogeneity of hepatic parenchyma on CT and MRI is also common but not specific. [33][34][35] Intraabdominal lymphadenopathy may be present up to 40 to 60% of cases, mainly located in the periportal and gastrohepatic areas. 36,37 Focal hepatic lesions may be found in 5 to 38% of patients, consisting of nodules of 0.5 to 1.5 cm, hypodense on CT or hypointense on MRI, with or without calcifications.…”

Particularities of Hepatic Sarcoidosis

“…The latest review on the importance of CEUS in the evaluation of abdominal involvement in sarcoidosis describes the following characteristics [47]:…”

“…Endoscopic ultrasound elastography could also be used to characterize liver sarcoidosis [47]. The lesions may appear as single masses with blue hard patterns within and around.…”

Does lymph node morphology using ultrasound reflect aetiology? A pictorial essay, part I

“…Transcutaneous ultrasound (US) is the primary imaging technique in the evaluation of peripherally located lymph nodes (LNs) [1][2][3]. In the abdomen and chest, computed tomography (CT) is usually the standard imaging method for staging purposes according to oncological guidelines [4][5][6][7][8][9][10][11][12]. In the mediastinum, endo-scopic ultrasound (EUS) techniques are often necessary for biopsy and cytological and/or histological evaluation [13][14][15][16][17][18][19][20][21].…”

“…Large LNs, often considered to be malignant, are seen in mononucleosis (fig 16), sarcoidosis [9,13,14,16,46,47] ( fig 17), in autoimmune diseases in general ( fig 18) and in TB [48][49][50] (fig 19, fig 20). Large abscessing LN infec-tions are seen in tularemia (rabbit plague) (fig 21, fig 22).…”