Splenic focal lesions as manifestation of sarcoidosis: Characterization with contrast-enhanced sonography.
We report the case of a 74-year-old woman with elevated liver enzyme levels in whom abdominal sonographic examination revealed a diffusely heterogeneous liver parenchyma and multiple hypoechoic subcentimetric splenic nodules. Contrast-enhanced sonography (CEUS) revealed that the splenic focal lesions did not enhance. CT examination revealed a low-density, multinodular pattern both in the liver and in the spleen. Core biopsy of 1 hepatic nodule revealed noncaseating epithelioid cell granuloma, and the patient was diagnosed with systemic sarcoidosis. CEUS has shown to be useful in the diagnosis of focal hepatic lesions, but studies referring to splenic lesions are lacking.
Pérez-Grueso
María José
MJ
Department of Gastroenterology, Virgen de la Salud Hospital, Avda Barber no. 30, Toledo 45004, Spain.
Repiso
Alejandro
A
Gómez
Rafael
R
Gonzalez
Concepción
C
de Artaza
Tomás
T
Valle
Julio
J
García
Almudena
A
Carrobles
Jose María
JM
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001706:Biopsy; D001799:Blood Sedimentation; D002097:C-Reactive Protein; D003287:Contrast Media / Q000008:administration & dosage*; D003920:Diabetes Mellitus; D003937:Diagnosis, Differential; D015622:Epithelioid Cells / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D007089:Image Enhancement / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D010743:Phospholipids; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*; D013154:Spleen / Q000000981:diagnostic imaging*; D013158:Splenic Diseases / Q000175:diagnosis*; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D013459:Sulfur Hexafluoride