Isolated hepatic sarcoidosis: A case series

Abstract

Sarcoidosis is a multi-organ inflammatory disease that can have hepatic involvement in up to 80% of cases. Rarely, sarcoidosis can manifest with only confined disease to the liver. While most patients with hepatic sarcoidosis are clinically silent, certain cases can have insidious onset leading to cirrhosis and secondary complications. Here, we describe three cases of isolated hepatic sarcoidosis to illustrate the range of presentations that may be associated with this condition. Clinicians should be vigilant in consideration of hepatic sarcoidosis as a culprit when investigating patients with undifferentiated liver disease.

Keywords: case; hepatic; isolated; liver; sarcoidosis; series.

Figure 1a:

CT abdomen showing a coarse granular appearance of the liver and spleen due to diffuse punctate lesions from infiltrative process

Figure 1b:

5-months follow-up liver MRI showing spontaneous resolution of previous infiltrative lesions

Figure 2:

Liver biopsy showing numerous non-necrotizing, well-formed, epithelioid granulomata (*). Many are confluent and some have associated fibrosis (arrows). The granulomata are also compressing adjacent bile ducts (green circles), resulting in a pattern of secondary sclerosing cholangitis