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Radiology, Vol 195, 757-762, Copyright © 1995 by Radiological Society of North America

ARTICLES

Nodular sarcoidosis of the liver and spleen: analysis of 32 cases

DM Warshauer, PL Molina, SM Hamman, RE Koehler, EK Paulson, RE Bechtold, ML Perlmutter, JN Hiken, IR Francis and CJ Cooper
Department of Radiology, University of North Carolina School of Medicine, Chapel Hill 27599-7510, USA.

PURPOSE: To describe the computed tomographic (CT) appearance of nodular hepatosplenic sarcoidosis and its association with stage with chest radiography and clinical status. MATERIALS AND METHODS: Thirty- two patients (21 women, 11 men; aged 25-68 years) with nodular hepatosplenic sarcoidosis were evaluated. CT findings were described along with chest radiographic stage, clinical status, and level of angiotensin-converting enzyme (ACE). RESULTS: Nodules were small, multiple, and of low attenuation. Organomegaly was common. Abdominal adenopathy was present in 76% of the patients. Chest radiographs were normal in 25%; 61% had stage 1 or 2 radiographs. Abdominal or systemic symptoms were present in 66%. ACE level was elevated in 10 (91%) of 11 patients tested. No change in chest radiographic stage was noted in 74% of patients with follow-up radiographs. CONCLUSION: Nodular hepatosplenic sarcoidosis is associated with organomegaly, adenopathy, and symptoms. Nodules were not associated with advanced lung disease and did not herald a change in chest radiographic stage. An elevated ACE level may be helpful in diagnosis.




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