Efficacy of additional treatment with azathioprine in a patient with prednisolone-dependent gastric sarcoidosis

Figure 1 Gastroendoscopy findings before corticosteroid treatment. A, B: Multiple map-like ulcerative lesions and ulcer scars are seen on the greater curvature of the body to the fornix and atrophic gastritis with Helicobacter pylori infection; C: Magnifying narrow-band imaging shows the absence of epithelial change at the edge of the ulcer; D: Endoscopic ultrasonography reveals thickness and irregularity in the second layer of the gastric wall.

Figure 2 Histopathologic findings of the gastric mucosal biopsy specimen before corticosteroid treatment. The mucosal layer of the gastric wall shows multiple noncaseating granulomas and infiltration of inflammatory cells, especially lymphocytes. A: HE, magnification × 10; B: HE, magnification × 20. HE: Hematoxylin and eosin.

Figure 3 Gastroendoscopy and histopathologic findings after concomitant treatment with corticosteroid and azathioprine. A, B: Most of the sarcoidosis-related gastric ulcers in the fornix are healed; C, D: Gastric mucosal granuloma and lymphocytic infiltration is decreased; C: HE, magnification × 10; D: HE, magnification × 20. HE: Hematoxylin and eosin.