Hepatic sarcoidosis in patients presenting with liver dysfunction: imaging appearance, pathological correlation and...

Area of Science:

• Hepatology
• Radiology
• Pulmonology

Background:

• Hepatic sarcoidosis is a granulomatous disease that can affect the liver.
• The progression and imaging features of hepatic sarcoidosis, particularly in relation to thoracic disease, require further elucidation.

Purpose of the Study:

• To assess the imaging appearance and progression of hepatic sarcoidosis in patients presenting with liver dysfunction.
• To determine if hepatic sarcoidosis can lead to cirrhosis and portal hypertension independently of thoracic sarcoidosis.

Main Methods:

• Retrospective review of 39 patients with sarcoidosis-related liver dysfunction.
• Analysis of baseline and follow-up imaging by abdominal radiologists, including chest CT.
• Collection of clinical information and scoring of cirrhotic and portal hypertension features.

Main Results:

• At presentation, a majority of patients showed features of cirrhosis and portal hypertension.
• Over a mean of 4.7 years, a significant proportion of patients demonstrated worsening cirrhotic features.
• Hepatic disease severity showed poor correlation with thoracic sarcoidosis extent, with a mean 7.2-year interval between pulmonary and liver involvement diagnoses.

Conclusions:

• Hepatic sarcoidosis can present as liver dysfunction, cirrhosis, or portal hypertension.
• Sarcoid-related liver disease may progress independently and manifest at various times relative to pulmonary disease.
• Imaging can identify cirrhotic features and portal hypertension, though focal liver lesions often regress.