An Endoscopic Ultrasound-guided Fine-needle Biopsy as a Diagnostic Tool for Isolated Hepatic Sarcoidosis

A 72-year-old man was referred for the evaluation of multiple hepatic lesions incidentally detected on contrast-enhanced computed tomography during prostate cancer staging. Imaging could not exclude malignancy, but the tumor markers were within the normal limits, except for prostate-specific antigen, and endoscopic examinations revealed no primary malignancy. A percutaneous biopsy was not feasible because of the lesion size and location. Endoscopic ultrasound (EUS) revealed a 25-mm caudate lobe lesion, from which fine-needle biopsy (FNB) was performed without complications. A histopathological examination confirmed a diagnosis of hepatic sarcoidosis. This case highlights the utility of EUS-FNB for the diagnosis of hepatic sarcoidosis, especially when a conventional biopsy is impractical.