TWO CASES OF GASTRIC SARCOIDOSIS

Abstract

A case of histologically proven gastric sarcoidosis in a patient who was operated on under a suspected diagnosis of gastric cancer and another case of pm invasive cancer of the stomach with sarcoid nodules found in the regional lymph nodes and gastric walls are reported. Case 1: A 68-year-old male with the chief complaint of anorexia was noted on barium swallow to have fibrotic changes in the walls of the middle and lower portions of the stomach on the greater and lesser curvature. Gastroscopy revealed erosion and ulcers of irragular shape in the same areas, but biopsy proved negative. Because the possibility of diffuse carcinoma or malignant lymphoma of the stomach could not be ruled out, total gastrectomy was performed. Histologically, there were noted epithelioid granulomas containing giant cells of Langhans and involving the deep mucosal layers and the serosa of the entire stomach and sarcoid nodules in all resected lymph nodes, and a diagnosis of gastric sarcoidosis was thus made.Case 2: A 52-year-old male was admitted to the hospital because of epigastric pain. With gastroscopy and barium swallow, a IIc lesion on the anterior wall of the lower portion of the stomach as diagnosed as being a signet-ring cell carcinoma of a depth of invasion of pm. Minute intramucosal epithelioid granulomas were also found in the pyloric region. As few reports are available so far on sarcoidosis of the digestive tract, notably stomach, its clinical significance was studied and discussed.