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Gastroenterology
Hepatic sarcoid resembling lymphoma
  1. Vikram Rao1,
  2. Sarah Lucas1 and
  3. Jonathan P Segal2
  1. 1Department of Gastroenterology, Western Health, Footscray, Victoria, Australia
  2. 2Department of Gastroenterology, The Royal Melbourne Hospital City Campus, Parkville, Victoria, Australia
  1. Correspondence to Dr Vikram Rao; vickrams.rao{at}gmail.com

Abstract

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.

  • Liver disease
  • Haematology (incl blood transfusion)
  • Gastroenterology

https://doi.org/10.1136/bcr-2024-260220

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: VR and SL. VR and SL are the main authors of this case report and contributed to conception, planning and composition of the case report. They were also involved in reviewing the literature and finalising the manuscript. The following author gave final approval of the manuscript: JPS. JPS contributed to supervising and planning the composition of the case report, and was also involved in supervising and finalising the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.