title: Contrast-enhanced ultrasonography in hepatosplenic sarcoidosis.
abstract: We report a case of a 38-year-old woman with atypical pain in the left lower hemi-abdomen. On abdominal B-mode ultrasonography the liver was normal; the spleen showed multiple subcentimetric hypoechoic nodules. A multidetector CT-examination revealed multiple small low-attenuation nodules in the liver and the spleen, suggestive for metastatic disease. Contrast-enhanced ultrasound (CEUS) revealed two hypoechoic nodules in the liver that were visible in the portal phase and disappeared in the late phase. The focal splenic lesions were visible as irregular hypo-enhancing nodules. An MRI examination, including T1, T2 and contrast-enhanced images, could not confirm the exact nature of the lesions. A core biopsy of a splenic nodule yielded non-caseating epithelioid cell granulomas. Different complementary examinations were normal and hepatosplenic sarcoidosis was diagnosed. The pain in the left lower hemi-abdomen was ascribed to irritable bowel syndrome.
authors.affiliation: Department of Internal and Infectious Diseases, University Hospital Ghent, De Pintelaan 185, 9000 Gent, Belgium. Marijke.Stryckers@Ugent.be
authors.forename: M
authors.initials: M
authors.lastname: Stryckers
authors.forename: D
authors.initials: D
authors.lastname: Voet
authors.forename: D
authors.initials: D
authors.lastname: Vogelaers
authors.forename: M
authors.initials: M
authors.lastname: Afschrift
authors.forename: K
authors.initials: K
authors.lastname: Verstraete
authors.forename: S
authors.initials: S
authors.lastname: Van Belle
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D012507:Sarcoidosis / Q000000981:diagnostic imaging*; D013158:Splenic Diseases / Q000000981:diagnostic imaging*; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D013459:Sulfur Hexafluoride