Oketani M, Tsubouchi H, Hori T, Sakamoto K, Kawakami S, Yoshimitsu N, Matsuo T, Hirono S, Shimoide Y, Miura T
Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Gastroenterol Jpn. 1992 Jun;27(3):414-7. doi: 10.1007/BF02777763.
An asymptomatic 49-year-old woman with a diffuse abnormal shadow detected on a routine chest rentogenogram was referred for evaluation. Ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) revealed space-occupying lesions in the liver and spleen. Lymphadenopathy was observed in the mediastinum and abdomen on CT, and multiple lesions of low signal intensity were observed in the spine on MRI. Furthermore, the presence of multiple tumorous nodules in the liver suggesting metastatic hepatic cancer was demonstrated on laparoscopy. Biopsy of the liver tumors revealed sarcoidosis; transbronchial biopsy specimens showed identical histological features. After administration of prednisolone for one month, the space-occupying lesions in the liver, spleen and spine improved. This case of sarcoidosis exhibited hepatic tumorous nodules and space-occupying lesions in the spleen and the spine which mimicked the presence of metastatic hepatic cancer.
一名49岁无症状女性在常规胸部X线检查时发现弥漫性异常阴影，遂转诊进行评估。超声、计算机断层扫描（CT）和磁共振成像（MRI）显示肝脏和脾脏有占位性病变。CT显示纵隔和腹部有淋巴结肿大，MRI显示脊柱有多个低信号强度病变。此外，腹腔镜检查发现肝脏有多个肿瘤结节，提示为转移性肝癌。肝脏肿瘤活检显示为结节病；经支气管活检标本显示出相同的组织学特征。给予泼尼松龙治疗1个月后，肝脏、脾脏和脊柱的占位性病变有所改善。该结节病病例表现为肝脏肿瘤结节以及脾脏和脊柱的占位性病变，酷似转移性肝癌。
