Case 265: Sarcoidosis

Diagnostic Categories:

Clinical Presentation:

62 year old man with left lower quadrant pain for years and incidental finding on CT.

CT: Small granulomas

Imaging Findings:

Arterial phase CT shows multiple well-defined non-enhancing hypodense foci of similar size, which are most conspicuous on the portal venous phase and are isodense to liver parenchyma on the equilibrium image. The lateral most lesion demonstrates a hypovascular linear perfusion anomaly.

Even though is a nonspecific imaging finding, the differential diagnosis can be limited to metastatic disease and microabscesses.  Biopsy  of one of the lesions confirmed non-necrotizing granulomas with fibrosis typical for sarcoidosis, no signs of active infection.