A case of gastric sarcoidosis

Abstract

A 50-year-old female was pointed out to have abnormalities by a barium meal for medical checkup and visited our hospital. At the age of 40, she had been pointed out to have mediastinal lymphadenopathy by a chest X ray for medical checkup. At another hospital, biopsy of the lymphnode had been done and the diagnosis of sarcoidosis had been made. She was free of gastrointestinal symptoms and her fecal occult blood test was negative. Gastroscopy showed multiple protruding lesions in the fornix, body and angulus. Center of the lesion was yellowish and slightly depressed. Some of the lesions were also accompanied with converging folds. Endoscopic ultrasonography of the lesion showed a thickened hypoechoic area in the second inner layer. Biopsy specimens taken from the lesions showed non-caseous epithelioid granulomas with Langhans' giant cells in the lamina propria microscopically. Neither tubercle bacillus nor fungus was found. Serological tests of syphilis were also negative. These findings led to the diagnosis of gastric sarcoidosis. An ulcer scar with Helicobacter pylori infection was also observed in the stomach, then eradication of H. pylori was preformed. Her gastroscopic finding has not changed during the follow-up period (about 1 year) .