Symptomatic gastric sarcoidosis in a patient with pulmonary sarcoidosis in remission

Abstract

Sarcoidosis is a multisystem, non-infectious, granulomatous disease of unknown cause, characterised by histological evidence of non-caseating granulomas. Gastrointestinal (GI) involvement is uncommon, reported in <1% of patients with the disease. Herein, we present a rare case of isolated gastric sarcoidosis in a patient with latent pulmonary sarcoidosis and unexplained manifestations of GI disease, illustrating that clinical disease expression is variable; may be organ-specific; and, known disease latency confined to one organ does not exclude the possibility of active disease in another organ system. In patients with organ-specific sarcoidosis, whether active or in remission, presenting with GI symptoms, the possibility of gastric sarcoidosis should be considered. Oesophagogastroduodenoscopy and biopsy, when indicated, should be considered for definitive diagnosis.

Figure 1

Oesophagogastroduodenoscopy demonstrating atrophic mucosa within the gastric body and antrum of the stomach.

Figure 2

Histopathology of the gastric antrum from an oesophagogastroduodenoscopy specimen. There is (A) granulomatous gastritis with multiple, well-formed, non-necrotising granulomas and focal minimal active inflammation (H&E stain × 40) and (B) granuloma composed of epithelioid histiocytes, surrounded by lymphocytes (H&E stain × 200).