SARCOIDOSIS WITH MULTIPLE HEPATIC AND SPLENIC NODULES ON DYNAMIC COMPUTED-TOMOGRAPHY

Four patients with extrapulmonary manifestations of sarcoidosis were found to have diffuse hypodense lesions in the liver and spleen by dynamic computed tomography. Three patients presented with weight loss and abdominal pain and, of this group, two had hepatosplenomegaly. The fourth patient was presented with a peripheral neuropathy. The alkaline phosphatase level was elevated in all patients, with elevated transaminases seen in only one patient. Two patients had hypercalcemia. Chest radiographs showed perihilar infiltrates in two patients and were normal in two. Initial impressions of their symptoms and computed tomography findings included neoplastic, infectious, and neurologic processes. The correct diagnosis was made by liver biopsy, which revealed non-necrotizing granulomas.