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Hepatic and splenic involvement of sarcoidosis
Sarcoidosis de afectación hepatoesplénica
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The laboratory tests revealed normal bilirubin, alkaline phosphatase 144 IU/l, GGT 186 IU/l, GOT 23 IU/l and GPT 34 IU/l.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The abdominal ultrasound revealed small peripheral hypoechoic areas scattered throughout the liver parenchyma and pathological nodes in the hilum of the liver indicating malignancy.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The study was completed with an abdominal tomography, which showed hepatomegaly with multiple hypodense hepatic and splenic lesions indicating metastasis in addition to various subcarinal, para-aortic and inguinal adenopathies (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">A biopsy of an inguinal adenopathy was performed to identify the possible primary lesion, yielding a lymph node with non-caseating chronic granulomatous sarcoid-type inflammation. Histochemical techniques performed ruled out mycobacteria and fungi.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Sarcoidosis is a chronic multisystemic disease characterised by the accumulation of inflammatory cells with the formation of non-caseating granulomas,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> with the lung and hilar lymph nodes being the most commonly affected organs. Digestive involvement is infrequent,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> and even more so hepatosplenic extension, and an infectious disease such as tuberculosis, fungal diseases, leishmaniasis, etc., or symptoms indicating malignancy, such as lymphomas or metastasis, should be ruled out.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1035 "Ancho" => 2093 "Tamanyo" => 176622 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronal and transverse sections of abdominal CT showing multiple hepatosplenic lesions consistent with sarcoidosis involvement.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated hepatic sarcoidosis, an unusual form of presentation of a systemic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. 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"fecha" => "2015" "volumen" => "10" "numero" => "4" "paginaInicial" => "2166" "paginaFinal" => "2170" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26622813" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004500000009/v2_202301300757/S2444382422001614/v2_202301300757/en/main.assets" "Apartado" => array:4 [ "identificador" => "75461" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004500000009/v2_202301300757/S2444382422001614/v2_202301300757/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382422001614?idApp=UINPBA00004N" ]
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