Diagnostic Challenge in Pancreatic Sarcoidosis Using Endoscopic Ultrasonography

Intern Med. 2018 Jan 15;57(2):231-235. doi: 10.2169/internalmedicine.9084-17. Epub 2017 Oct 16.

Abstract

We herein report a 55-year-old woman who presented with erythema and bilateral hilar lymphadenopathy 4 months prior to the detection of pancreatic lesions on an ultrasound. A skin biopsy showed evidence of sarcoidosis. The largest lesion in the tail of the pancreas was hypoechoic on endoscopic ultrasonography (EUS). The lesion was initially iso-enhanced on contrast enhanced-EUS (CE-EUS) but subsequently became hypoenhanced. The lesion revealed heterogeneous components of both soft and hard tissue on EUS elastography. She was ultimately diagnosed with pancreatic sarcoidosis based on the presence of noncaseating granulomas seen on pancreatic tissue retrieved through an EUS-guided fine needle aspiration biopsy.

Keywords: EUS elastography; contrast enhanced-EUS; endoscopic ultrasonography (EUS); pancreas; sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Biopsy, Fine-Needle
  • Endosonography
  • Female
  • Humans
  • Middle Aged
  • Pancreas / pathology
  • Pancreatic Diseases / diagnosis*
  • Pancreatic Diseases / diagnostic imaging
  • Pancreatic Diseases / pathology
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / diagnostic imaging
  • Sarcoidosis / pathology