[Sarcoidosis of the liver and spleen in Japan]

Although liver and/or spleen sarcoidosis usually shows no symptoms and subtle elevated levels of liver enzymes, diagnostic image scanning methods (abdominal ultrasonic scan, computed tomographic scan, magnetic resonance image, and Ga and Tc scintiscan) can easily detect the lesion. Laparoscopy unveils isolated scattered sarcoid nodules on the surface of the liver and/or spleen and biopsied specimen reveal a non-caseating epithelioid granuloma containing multinucleated giant cells especially in the portal area. Sometimes it is required to differentiate liver and/or spleen sarcoidosis from hepatic tuberculosis, primary biliary cirrhosis or malignant lymphoma. In severe cases, corticosteroid treatment is necessary. Prognosis is usually good, but may be poor in some cases.