Sarcoidosis Presenting as Space Occupying Lesions in Liver

This case report illustrates a typical presentation of hepatic sarcoidosis, a granulomatous liver disease that often manifests as an extrapulmonary feature of systemic sarcoidosis. The patient, a 60-year-old female, exhibited dyspeptic symptoms and anorexia. An abdominal ultrasound revealed space-occupying lesions in the liver, and elevated levels of alkaline phosphatase and gamma-glutamyl transferase were noted. Liver biopsy findings showed Grade 2 macrovesicular steatosis and noncaseating granulomatous inflammation. In addition, significantly elevated angiotensin-converting enzyme levels were observed, further supporting the diagnosis. This case underscores the importance of recognizing hepatic granulomatous foci, which can be crucial in determining the etiology and facilitating the diagnosis of sarcoidosis. The combination of clinical, biochemical, and histological findings played a pivotal role in diagnosing systemic sarcoidosis with hepatic involvement.