Sarcoidosis: single bulky mesenteric lymph node mimicking a lymphoma

A previously healthy man presented with acute abdominal pain that extended from the left lumbar area to the left iliac fossa and to the omolateral testicular region. Abdominal ultrasonography and CT scan showed a bulky mesenteric mass and mesenteric, paraaortic, and paracaval lymph nodes. Biopsy specimens of the mass revealed non caseating granulomas. Chest CT scan and 67Gallium thoracic scan demonstrated lymph node and parenchymal pulmonary involvement. Bronchoalveolar lavage (BAL) confirmed the presence of a low intensity alveolitis. Serum angiotensin converting enzyme (SACE) level was elevated. Two years after steroid therapy, markers of disease activity and abdominal ultrasonography are in the normal range.