Lee Seung Wook, Lee Min Hee, Lee Ji Eun, Choi Seo Youn, Yi Boem Ha, Jung Jung Min
Department of Radiology.
Department of Pathology Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, South Korea.
Medicine (Baltimore). 2019 Jun;98(24):e16001. doi: 10.1097/MD.0000000000016001.
Sarcoidosis is an idiopathic granulomatous disease. Although the lungs are most commonly involved, any organ may be affected. To assist with future diagnoses, we describe a rare case of peritoneal sarcoidosis in a young female patient, and present a literature review.
A 32-year-old female patient presented to our institution with abdominal discomfort. She was evaluated with contrast-enhanced abdominal computed tomography (CT), and multiple enlarged lymph nodes were detected at the hepatic artery and left gastric artery nodal stations. The patient was lost during follow-up, but returned after 7 months and again underwent abdominal CT. This revealed diffuse nodular thickening of the peritoneum and the appearance of omental cake in her abdomen.
Excisional biopsy of a lymph node was performed and extrapulmonary sarcoidosis was confirmed.
The patient was treated with corticosteroid.
A follow-up abdominal CT scan after two weeks revealed decreases in the numbers and sizes of the previously enlarged lymph nodes, and improvement in the ascites and peritoneal thickening.
Peritoneal sarcoidosis should be considered as an additional differential diagnosis when peritoneal carcinomatosis or tuberculous peritonitis are suspected. In this regard, serum levels of angiotensin-converting enzyme (ACE) may be a valuable diagnostic indicator of unusual sarcoidosis presentations.
结节病是一种特发性肉芽肿性疾病。虽然肺部最常受累,但任何器官都可能受到影响。为了辅助未来的诊断,我们描述了一名年轻女性患者的罕见腹膜结节病病例,并进行文献综述。
一名32岁女性患者因腹部不适前来我院就诊。她接受了腹部增强计算机断层扫描(CT)检查,在肝动脉和胃左动脉淋巴结部位发现多个肿大淋巴结。该患者在随访期间失访,但7个月后返回并再次接受腹部CT检查。结果显示腹膜弥漫性结节状增厚,腹部出现网膜饼征。
对一个淋巴结进行切除活检,确诊为肺外结节病。
患者接受了糖皮质激素治疗。
两周后的随访腹部CT扫描显示,先前肿大的淋巴结数量和大小减少,腹水和腹膜增厚情况有所改善。
当怀疑腹膜癌或结核性腹膜炎时,应将腹膜结节病作为额外的鉴别诊断考虑。在这方面,血清血管紧张素转换酶(ACE)水平可能是不寻常结节病表现的有价值诊断指标。