Sarcoidosis: abdominal manifestations at CT.

There are few data in the literature on the abdominal manifestations of sarcoidosis at computed tomography (CT). To determine whether differences in nodal distribution and appearance can be reliably used to distinguish between sarcoidosis and non-Hodgkin lymphoma (NHL), the authors retrospectively reviewed the abdominal and pelvic CT scans of 16 patients with biopsy-proved sarcoidosis and 20 patients with biopsy-proved NHL. Eleven of the 16 patients with sarcoidosis had abdominal and/or pelvic lymphadenopathy, which was common at all nodal sites except for the retrocrural and pelvic locations. There was a statistically significant lower frequency of retrocrual adenopathy in sarcoidosis than in NHL. Mean nodal size was significantly greater in NHL. Nodes tended to be confluent in NHL and discrete in sarcoidosis. Hepatomegaly was seen in six of the 16 patients (38%) with sarcoidosis and splenomegaly was present in nine of 15 (60%). CT depicted hepatic lesions in only three of eight patients (38%) with biopsy-proved hepatic involvement. Splenic lesions were seen at CT in five of the 15 patients (33%). The authors believe that the overlap in nodal appearance and distribution poses a limitation for use of these criteria in accurate disease characterization.