Aseptic lung and liver abscesses: a diagnostic challenge

Area of Science:

• Internal Medicine
• Pulmonology
• Gastroenterology

Background:

• Systemic sarcoidosis is a multisystem inflammatory disease of unknown etiology.
• Pulmonary involvement is common, but extrapulmonary manifestations can occur.

Observation:

• A 67-year-old man with known sarcoidosis presented with cough and chest pain, revealing pulmonary nodules on CT.
• Biopsies showed abscesses, initially treated successfully with prednisone.
• A relapse three years later involved lung and liver lesions, characterized by elevated CRP and cholestasis.

Findings:

• Liver biopsies excluded neoplastic or infectious causes, showing inflammatory granulation tissue with abscess formation.
• A diagnosis of sarcoidosis-associated aseptic abscesses syndrome was established.
• The patient responded well to corticosteroid therapy.

Implications:

• This case highlights a rare presentation of sarcoidosis, emphasizing the need for considering sarcoidosis-associated aseptic abscesses syndrome in relevant clinical contexts.
• Corticosteroids are a key treatment modality for this syndrome.
• Further research into the pathogenesis and management of sarcoidosis-associated aseptic abscesses is warranted.