Peritoneal sarcoidosis: A case report

Medicine (Baltimore). 2019 Jun;98(24):e16001. doi: 10.1097/MD.0000000000016001.

Abstract

Rationale: 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.

Patient concerns: 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.

Diagnosis: Excisional biopsy of a lymph node was performed and extrapulmonary sarcoidosis was confirmed.

Interventions: The patient was treated with corticosteroid.

Outcomes: 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.

Lessions: 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.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery*
  • Peritoneal Diseases / diagnostic imaging*
  • Peritoneal Diseases / drug therapy
  • Peritoneal Diseases / pathology
  • Sarcoidosis / diagnostic imaging*
  • Sarcoidosis / drug therapy
  • Sarcoidosis / pathology
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones