2021 Volume 48 Issue 2 Pages 101-105
Sarcoidosis is a granulomatous disease of unknown etiology that can vary from asymptomatic to life-threatening. It is a systemic disease that can affect any organ, including the liver. Because hepatic involvement is usually asymptomatic and cannot be depicted clearly on B-mode ultrasound images, it is often underdiagnosed. Here, we report a case of a patient with hepatic sarcoidosis that was diagnosed histologically by contrast-enhanced ultrasound-guided needle biopsy. Case report: A 78-year-old woman with pulmonary sarcoidosis and multiple hepatic nodules was admitted to our hospital for diagnosis of hepatic nodules. Dynamic contrast-enhanced computed tomography demonstrated multiple hypovascular nodules in the liver. These nodules could be recognized on contrast-enhanced ultrasound but could not be depicted clearly on B-mode ultrasound images. They were shown as a perfusion defect in the postvascular phase. Thus, contrast-enhanced ultrasound-guided needle biopsy was performed, and the patient was diagnosed with hepatic sarcoidosis. Due to insufficient staining with PAS-D, dysfunction of Kupffer cells in granuloma was speculated. This case report demonstrated that it is important to perform contrast-enhanced ultrasonography, and this can be the modality used to guide biopsy for patients with hepatic sarcoidosis if the hepatic lesions cannot be depicted on routine B-mode ultrasound images.
