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World J Clin Cases. Apr 6, 2019; 7(7): 809-818
Published online Apr 6, 2019. doi: 10.12998/wjcc.v7.i7.809
Ultrasound imaging of abdominal sarcoidosis: State of the art
Claudio Tana, Cosima Schiavone, Andrea Ticinesi, Fabrizio Ricci, Maria Adele Giamberardino, Francesco Cipollone, Mauro Silingardi, Tiziana Meschi, Christoph F Dietrich
Claudio Tana, Andrea Ticinesi, Tiziana Meschi, Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, and Department of Medicine and Surgery, University-Hospital of Parma, Parma 43126, Italy
Cosima Schiavone, Department of Internistic Ultrasound, “G. D’Annunzio” University of Chieti, Chieti 66100, Italy
Fabrizio Ricci, Department of Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti, Chieti 66100, Italy
Maria Adele Giamberardino, Geriatrics Clinic, Department of Medicine and Science of Aging, “G. D’Annunzio” University of Chieti, Chieti 66100, Italy
Francesco Cipollone, Medical Clinic, Department of Medicine and Science of Aging, “G. D’Annunzio” University of Chieti, Chieti 66100, Italy
Mauro Silingardi, Internal Medicine Unit, Maggiore Hospital of Bologna, Bologna 40133, Italy
Christoph F Dietrich, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim D-97980, Germany
Author contributions: All authors equally contributed to this paper with the conception, and design of the study, literature review and analysis, drafting and critical revision, and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Claudio Tana, MD, Doctor, Medical Assistant, Internal Medicine and Subacute Care Unit, Medicine-Geriatric Rehabilitation Department, University Hospital of Parma, Via Antonio Gramsci 14, Parma 43126, Italy. ctana@ao.pr.it
Telephone: +39-521-704316 Fax: +39-521-704316
Received: January 21, 2019
Peer-review started: January 21, 2019
First decision: February 13, 2019
Revised: March 8, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 6, 2019
Processing time: 75 Days and 22.4 Hours
Abstract

Since it has been recognized that sarcoidosis (SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound (US) is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs (e.g., lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.

Keywords: Sarcoidosis; Sarcoid lesions; Granulomatous disorders; Liver; Spleen; Rare diseases; Ultrasound; Contrast-enhanced ultrasound

Core tip: Ultrasound (US) is useful to evaluate patients with suspected abdominal sarcoidosis (SA), showing some findings such as organomegaly, hypoechoic lesions and adenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs (e.g., lungs) the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Our objective was to critically review the role of US in abdominal SA, reporting characteristic findings and limitations of current evidence and discussing future perspectives of study.