Sarcoidosis - hepatic and splenic involvement

Case contributed by Dr Lukas Valkovic

Presentation

Patient with 2 years history of pulmonary sarcoidosis.

Patient Data

Age: 45 years
Gender: Male
MRI

MRI Abdomen

There is a multinodular bilobar infiltration of the liver also with several slightly bigger similar lesions in the spleen. They appear hypointense in T2, isointense in T1 (not shown) with marked hypointensity after contrast injection. No organomegaly. Findings correspond well with known sarcoidosis. 

Case Discussion

Sarcoidosis is a multi-system disorder of unknown etiology characterized by the presence of widespread, noncaseating granulomas, with formation occurring in all affected tissues. The granulomas may resolve spontaneously or progress to fibrosis.

Although the involvement of abdominal viscera is less frequent than pulmonary and mediastinal disease when it occurs, it may mimic more common infectious or neoplastic conditions and result in unnecessary morbidity.

Imaging findings usually consist of either homogeneous organomegaly or nodular infiltration.

Histologically, the diameter of granulomatous lesions in the liver is generally < 2 mm. The appearance of the larger lesions is probably caused by a coalescence of small granulomas.

Some patients with marked hepatosplenomegaly have no lesions, on the other hand, nodular lesions can be seen in patients who have only slight enlargement of the liver and spleen.

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Case information

rID: 61769
Published: 19th Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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