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A case of liver sarcoidosis mimicking cirrhosis

Spyridon P Dourakis1, Demosthenis D Cokkinos, Aspasia S Soultati

  • 12nd Department of Internal Medicine, University of Athens Medical School, Hippocration General Hospital, 114 Vas Sofias Avenues, 11527, Athens, Greece. spdour@med.uoa.gr

Clinical Imaging
|December 27, 2006
PubMed

Insights

Liver sarcoidosis is rare and can mimic cirrhosis on imaging. This case highlights the importance of biopsy for accurate diagnosis of hepatic sarcoidosis, even when imaging suggests cirrhosis.

Area of Science:

  • Hepatology
  • Radiology
  • Pathology

Background:

  • Sarcoidosis commonly affects the liver, with autopsy series reporting granulomas in up to 70% of patients.
  • Computed tomography (CT) detection of hepatic and splenic lesions in sarcoidosis is less frequent, occurring in 5% and 15% of cases, respectively.
  • Liver sarcoidosis can present atypically, challenging diagnostic interpretation.

Observation:

  • A rare case of liver sarcoidosis mimicking macronodular cirrhosis is presented.
  • Initial imaging findings, including CT scans, were consistent with liver cirrhosis.
  • The patient's imaging suggested advanced liver disease, necessitating further investigation.

Findings:

  • Liver biopsy revealed sarcoid granulomas in portal and lobular areas.
  • Crucially, no significant fibrotic lesions, typical of cirrhosis, were identified on biopsy.
  • Histological examination confirmed sarcoidosis as the underlying cause of the liver abnormalities.

Implications:

  • This case underscores the diagnostic challenges in liver sarcoidosis.
  • It emphasizes the critical role of liver biopsy in differentiating sarcoidosis from cirrhosis when imaging is equivocal.
  • Accurate diagnosis through integrated histological and imaging assessment is vital for appropriate patient management.

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