Diagnostic Challenge in Pancreatic Sarcoidosis Using Endoscopic Ultrasonography

作者：Azemoto Nobuaki; Kumagi Teru; Koizumi Mitsuhito; Kuroda Taira; Yamanishi Hirofumi; Ohno Yoshinori; Imamura Yoshiki; Takeshita Eiji; Soga Yoshiko; Ikeda Yoshiou; Onji Morikazu; Hiasa Yoichi

来源：Internal Medicine, 2018, 57(2): 231-235.

DOI：10.2169/internalmedicine.9084-17

• pancreas
• sarcoidosis
• endoscopic ultrasonography (EUS)
• contrast enhanced-EUS
• EUS elastography

We herein report a 55-year-old woman who presented with erythema and bilateral hilar lymphadenopathy 4 months prior to the detection of pancreatic lesions on an ultrasound. A skin biopsy showed evidence of sarcoidosis. The largest lesion in the tail of the pancreas was hypoechoic on endoscopic ultrasonography (EUS). The lesion was initially iso-enhanced on contrast enhanced-EUS (CE-EUS) but subsequently became hypoenhanced. The lesion revealed heterogeneous components of both soft and hard tissue on EUS elastography. She was ultimately diagnosed with pancreatic sarcoidosis based on the presence of noncaseating granulomas seen on pancreatic tissue retrieved through an EUS-guided fine needle aspiration biopsy.

• 出版日期2018