Delayed enhanced hepatosplenic sarcoid nodules on computed tomography in an interferon-naïve hepatitis C patient: a case report and review of the literature.

A 77-year-old woman with chronic type C hepatitis was diagnosed with hypoechoic hepatosplenic nodules on ultrasonography. These lesions showed low density on precontrast computed tomography and delayed enhancement. Judging from laboratory data and images, the nodules were considered unlikely to represent malignancies and were followed conservatively. The hepatic lesions then increased in size and number. Sarcoidosis was diagnosed following liver biopsy. All nodules disappeared spontaneously within 6 years. Although some cases of interferon-induced sarcoidosis in patients with chronic hepatitis C or hepatitis C virus (HCV)-related cirrhosis have been reported recently, interferon-naïve cases are relatively rare. Delayed enhancement on computed tomography may reflect fibrosis of hepatic sarcoid lesions that have been histologically confirmed. Gastroenterologists managing patients with chronic HCV infection need to keep such cases in mind.