Department of Gastroenterology, Western Health, Footscray, Victoria, Australia
Department of Gastroenterology, Western Health, Footscray, Victoria, Australia.
BMJ Case Rep. 2024 Sep 4;17(9):e260220. doi: 10.1136/bcr-2024-260220.
Sarcoidosis is an inflammatory disease characterised by non-caseating granulomas that can affect any organ, although lung involvement is the most common. It is rare to find sarcoidosis isolated to extrapulmonary organs. We describe a case of extrapulmonary sarcoidosis with involvement of the liver in a man in his late 40s. His initial clinical history and investigations were more consistent with a diagnosis of lymphoma until a liver biopsy was performed revealing non-caseating granulomas more suggestive of a diagnosis of sarcoidosis. This patient had a history of young-onset ischaemic heart disease (IHD). We discuss the possible links between sarcoidosis, an inflammatory condition, and IHD, as well as the challenges to treating such patients with concurrent metabolic syndrome. This case also highlights the heterogeneous nature of sarcoidosis, with the diagnosis being important as prompt treatment can prevent complications of end-stage liver disease, including portal hypertension and cirrhosis.
结节病是一种炎症性疾病，其特征为非干酪样肉芽肿，可影响任何器官，但肺部受累最为常见。孤立性肺外器官结节病很少见。我们描述了一例 40 多岁男性的肺外结节病，其肝脏受累。他的初始临床病史和检查结果更符合淋巴瘤的诊断，直到进行了肝活检，显示出非干酪样肉芽肿，更提示结节病的诊断。该患者有早发性缺血性心脏病（IHD）病史。我们讨论了结节病（一种炎症性疾病）与 IHD 之间可能存在的联系，以及治疗此类同时患有代谢综合征的患者所面临的挑战。该病例还突出了结节病的异质性，及时诊断非常重要，因为及时治疗可以预防晚期肝病的并发症，包括门静脉高压和肝硬化。
