Saito Hiroaki, Ohmori Masayasu, Iwamuro Masaya, Tanaka Takehiro, Wada Nozomu, Yasunaka Tetsuya, Takaki Akinobu, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Saito Clinic, Japan.
Intern Med. 2017 Oct 1;56(19):2583-2588. doi: 10.2169/internalmedicine.8768-16. Epub 2017 Sep 6.
A 46-year-old woman presented with massive hematemesis, caused by the rupture of esophageal varices. The laboratory investigations showed pancytopenia, and imaging tests revealed hepatosplenomegaly and ascites. A diagnosis of systemic sarcoidosis was made based on biopsies of the liver, stomach, lungs, heart, and skin. Although fat deposition was predominant, non-caseating granuloma and cirrhotic changes were found in the liver. Non-caseating granuloma was also identified in a biopsy specimen from minute depressions of the gastric folds. This case illustrates the rare involvement of the digestive system in a case of systemic sarcoidosis.
一名46岁女性因食管静脉曲张破裂出现大量呕血。实验室检查显示全血细胞减少,影像学检查发现肝脾肿大和腹水。根据肝脏、胃、肺、心脏和皮肤活检结果诊断为系统性结节病。虽然肝脏中脂肪沉积占主导,但发现了非干酪样肉芽肿和肝硬化改变。在胃皱襞微小凹陷处的活检标本中也发现了非干酪样肉芽肿。该病例说明了系统性结节病累及消化系统的罕见情况。