Unfamiliar liver lesions (May 2022 [1])

Published: 06/01/2022

Authors: Damian Wong, Zi Qin Ng and Dieter Weber

A 22 year-old male patient underwent laparoscopic cholecystectomy for recurrent biliary colic. Multiple macroscopic pale lesions were noted on the liver surface. Histopathology confirmed non-caseating granulomas. Serum angiotensin-converting enzyme was elevated. These findings were suspicious for extrapulmonary manifestations of sarcoidosis. Up to 10 per cent of all liver biopsy specimens are granulomas. Of these, 22 per cent are due to sarcoidosis. This is mostly asymptomatic. Up to 40 per cent of patients however present with biochemical derangement or hepatomegaly.