A Case of Hepatic Sarcoidosis Diagnosed by Laparoscopic Findings

Abstract

We encountered one patient with hepatic sarcoidosis and conducted a clinical investigation of this patient together with 4 other patients who had so far been diagnosed as hepatic sarcoidosis by laparoscopic biopsy of the livers, based mainly on laparoscopic images and histopathological findings.
The five patients, consisting of 2 males and 3 females, were 30-59 years in age. For biochemical findings of the blood, TBil and γ-globulin levels were elevated in 2 patients and ALP rose in 3 patients. ACE was increased in 4 patients. For laparoscopic observations, the surface of the livers exhibited various levels of unevenness, ranging from smooth to highly uneven. The size and distribution of white sarcoid nodules observed on the liver surface varied from dotted nodules to map-like nodules. For histopathological findings, although uncaseous granuloma was found in 3 of the 5 patients, no granuloma was observed in deep tissues taken by liver biopsy in the remaining 2 patients.
It is considered that both laparoscopic and histological findings of the liver are important for definite diagnosis of liver sarcoidosis.