Pancreatic sarcoidosis

Sarcoidosis affects every organ in the body; the most frequently involved structures are the lung, lymph nodes, liver, spleen, eyes, joints and heart. Gastrointestinal system affliction is uncommon. The pancreas is rarely affected by sarcoidosis. A review of the literature revealed only 13 patients with biopsy proven granulomas in pancreas or peripancreatic nodes. In a review of all autopsies performed between 1950 and 1993 at Los Angeles County + University of Southern California School of Medicine, Los Angeles, USA, the authors found one patient with pancreatic and 5 with peripancreatic lymph node granuloma. The authors also describe three previously unreported cases of pancreatic sarcoidosis. From the discussion, a clinically useful and pragmatic profile of pancreatic sarcoidosis emerges. Two thirds of the patients with pancreatic sarcoidosis have abdominal pain, and three quarters of them have bilateral hilar adenopathy. The occurrence of abdominal pain in a woman with bilateral hilar adenopathy with or without pulmonary infiltration should lead one to think of pancreatic sarcoidosis. The diagnosis should be established by a tissue biopsy because the laboratory and radiographic techniques do not differentiate pancreatic sarcoidosis from other inflammatory and malignant disorders of the pancreas. The prognosis of pancreatic sarcoidosis is good.