Extensive Abdominal Sarcoidosis Without Pulmonary Manifestation

广泛性腹部结节病,无肺部表现

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Abstract

Background: Sarcoidosis is a rare multisystem disease of idiopathic etiology that affects different organs and is characterized histopathologically by the presence of noncaseating granulomas. The most common location of sarcoidosis is the lungs, accounting for approximately 95% of sarcoidosis cases. Coincident involvement of pulmonary and extrapulmonary organs is present in approximately one-third of patients. However, the sole involvement of intraabdominal organs is extremely rare. Intraabdominal sarcoidosis has a different presentation depending on the involved organs. To the best of our knowledge, a limited number of case reports have been published on intraabdominal sarcoidosis without pulmonary involvement. Case Report: A 69-year-old female patient presented with short onset of abdominal pain and change in bowel habits, without a significant medical history of abdominal problems. Physical examination only revealed generalized abdominal tenderness on deep palpation. Computed tomography of the abdomen and pelvis showed mild to moderate thickening of the omentum and other abdominal organs. After excluding various etiologies such as fungi and acid-fast bacilli, the omentum, ovaries, and surrounding lymph nodes were removed via a laparoscopic procedure. The histopathology report confirmed the diagnosis of intraabdominal sarcoidosis with the presence of noncaseating granulomas. Conclusion: Extrapulmonary sarcoidosis is a rare disease, and intraabdominal sarcoidosis might mimic other malignant etiologies. We treated our case with laparoscopic removal of involved organs and oral steroids with significant recovery during a short period.

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