Hepatic sarcoid mimicking metastatic disease.

 

HISTORY: 57-year-old male with abnormal liver function studies.

 

FINDINGS: Images 1-4 are longitudinal scans of the liver demonstrating

perihepatic ascites and a diffuse hypoechoic nodular pattern to the

liver.

DIAGNOSIS: Hepatic sarcoid mimicking metastatic disease.

DISCUSSION: The predominant sonographic finding in this case is multiple

hypoechoic nodules throughout the liver.  The differential diagnosis includes regenerative nodules from micronodular cirrhosis, metastatic disease, and other infiltrating processes such as granulomatous disease.

Microabscesses, although a consideration in the appropriate clinical setting, do not generally have this appearance and more often appear as target lesions.  Liver biopsy revealed non-caseating granulomas

consistent with sarcoid.