An Unorthodox Pancreatic Lesion in a Young Man Presenting With Jaundice

Schauer, Rolf; Völker, Uwe; Kreuzmayr, A

doi:10.1053/j.gastro.2010.09.012

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…Sarcoidosis involving the pancreas is very rare, particularly in the absence of systemic manifestations. A review of the English language literature identified a limited number of cases of sarcoidosis presenting with pancreatic symptoms without a known history of the disease, the majority of which have been published in the past three decades [1][2][3][4][5][6][7][8][9][10][11][12][13][14] (Table 1). There is a slight preponderance of females and African Americans among reported cases and most present in the fifth to seventh decades of life.…”

Section: Discussionmentioning

confidence: 99%

“…Following resection of pancreatic sarcoidosis in the absence of extrapancreatic involvement, however, it is unclear whether steroids are necessary for long term management. A few authors have reported long-term complete resolution of symptoms following surgical resection of the involved portion of the pancreas without the use of adjuvant steroids [2,9,11].…”

Section: Discussionmentioning

confidence: 99%

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Sarcoidosis Presenting with Primary Pancreatic Manifestations: A Case Report and Review of the Literature

Al-Sukhni

Qiu²,

Gabriel³

et al. 2016

J Mol Biomark Diagn

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Background: Pancreatic sarcoidosis in the absence of systemic sarcoidosis is a rare entity with few reported cases. Most described cases are in black females and typically involve the head of the pancreas. This report describes a case of sarcoidosis involving the tail of the pancreas in a Caucasian male.Case Presentation: A previously healthy 48 year old Caucasian male presented with abdominal pain following an episode of heavy alcohol ingestion. Serum amylase was elevated and imaging was consistent with acute pancreatitis. Workup ruled out gallstones or autoimmune pancreatitis and his presentation was attributed to alcohol use. Despite abstaining from further alcohol intake, his abdominal pain persisted for several weeks, and subsequent imaging revealed persistent pancreatitis with narrowing of the pancreatic duct in the tail with an associated area of hypoechogenicity. FNA of this region showed rare benign ductal epithelial cells without evidence of malignancy. He was offered resection for his ongoing symptoms and to rule out a malignancy as an underlying etiology. He underwent laparoscopic distal pancreatectomy and splenectomy. Pathology from the resected specimen showed non-necrotizing granulomas involving the pancreas, spleen and the majority of 25 resected lymph nodes. Acid-fast bacteria and Gomori methenamine silver stains were negative for fungal or mycobacterial organisms and there was no evidence of polarizable materials within these granulomas. These findings are consistent with sarcoidosis. The patient recovered and was discharged without complication. He was subsequently referred to a rheumatologist for further workup and management.Conclusions: Sarcoidosis can present with isolated pancreatic symptoms and may be difficult to distinguish from other causes of pancreatitis. In the absence of systemic disease, surgery alone may be both diagnostic and therapeutic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sarcoidosis Presenting with Primary Pancreatic Manifestations: A Case Report and Review of the Literature

Al-Sukhni

Qiu²,

Gabriel³

et al. 2016

J Mol Biomark Diagn

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“…In these cases, laboratory tests reveal an increase of alkaline phosphatases and total and direct bilirubin [ 12 ]. Rarely, cholestasis is associated with common bile duct compression by a mass in the pancreatic head or by enlarged perihepatic lymph nodes [ 13 ]. Only few cases complicated by cirrhosis and portal hypertension have been reported in the literature, and they present with ascites and/or bleeding from rupture of gastroesophageal varices [ 14 – 16 ].…”

Section: Clinical and Laboratory Findings In Hepatosplenic Sarcoidmentioning

confidence: 99%

Hepatosplenic Sarcoidosis: Contrast-Enhanced Ultrasound Findings and Implications for Clinical Practice

Tana

Dietrich

Schiavone

2014

BioMed Research International

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Sarcoidosis is a complex granulomatous disease that affects virtually every organ and tissue, with a prevalence that varies significantly among the sites involved. The role of conventional imaging, such as computed tomography and magnetic resonance imaging, in the assessment of hepatosplenic sarcoidosis is well established by revealing organ enlargement, multiple discrete nodules, and lymphadenopathy. In this review, we aim to describe contrast-enhanced ultrasound (CEUS) findings in liver and spleen involvement by sarcoidosis, reporting evidence from the literature and cases from our experience, after a brief update on safety profile, cost-effectiveness, and clinical indications of this novel technique. Furthermore, we highlight potential advantages of CEUS in assessing hepatosplenic sarcoidosis that may be useful in the clinical practice.

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“…Sarcoidosis is a chronic systemic disease of unknown origin characterized by the presence of noncaseating granulomas in the affected tissues (1,2). The disease commonly affects young and middle-aged adults and can involve multiple organ systems, typically the hilar lymph nodes (often bilaterally), lung, heart, liver, spleen, eyes, kidney, other lymph nodes, salivary glands, nervous system, muscles, and bones (3,4). However, other organs are rarely involved.…”

Section: Introductionmentioning

confidence: 99%

Isolated Pancreatic Sarcoidosis Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration

et al. 2020

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We herein report a 52-year-old man with multiple hypoechoic lesions in the body and tail of the pancreas detected during a screening ultrasound. Computed tomography (CT) showed no lesions other than those in the pancreas and peripheral lymph nodes. Contrast-enhanced CT identified hypovascular tumors in the pancreas. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) demonstrated partial fibrosis and noncaseating granulomas with Langhans giant cells. To our knowledge, this is the first report of isolated pancreatic sarcoidosis diagnosed by EUS-FNA. Although pancreatic sarcoidosis is very rare, clinicians should be aware of this possibility in patients presenting with multiple hypovascular pancreatic tumors.

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An Unorthodox Pancreatic Lesion in a Young Man Presenting With Jaundice

Cited by 5 publications

References 3 publications

Sarcoidosis Presenting with Primary Pancreatic Manifestations: A Case Report and Review of the Literature

Sarcoidosis Presenting with Primary Pancreatic Manifestations: A Case Report and Review of the Literature

Hepatosplenic Sarcoidosis: Contrast-Enhanced Ultrasound Findings and Implications for Clinical Practice

Isolated Pancreatic Sarcoidosis Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration

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