Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3380
Peer-review started: October 6, 2014
First decision: October 29, 2014
Revised: November 8, 2014
Accepted: December 16, 2014
Article in press: December 16, 2014
Published online: March 21, 2015
Sarcoidosis is a multisystem chronic inflammatory condition of unknown etiology that has the potential to involve every tissue in the body. Sarcoidosis in the gastrointestinal system, and particularly the colon, is very rare. Here, we report the case of a 57-year-old man with no previous diagnosis of sarcoidosis who presented with new onset of abdominal pain and constipation. A colonoscopy revealed that the abdominal pain was caused by an obstructing lesion in the cecum-ascending colon and lacked a clear histologic diagnosis. Radiologic investigation revealed concentric wall thickening of the cecum-ascending colon with multiple satellite lymphadenopathies, highly suggestive of a malignancy. The patient underwent a laparotomy and a right hemicolectomy was performed. A diagnosis of colonic sarcoidosis was made after the resected specimen was examined. Additionally, a chest computed tomography scan revealed lung involvement with atypical radiologic features in the absence of respiratory symptoms. Only histologic examination of the surgical specimen can yield a diagnosis of gastrointestinal sarcoidosis due to the non-specificity of endoscopic and radiologic findings.
Core tip: Gastrointestinal tract involvement in systemic sarcoidosis is rare. This case report of a patient with gastrointestinal sarcoidosis is clinically relevant because the colonic location highlights an unusual cause of abdominal pain. This study provides an opportunity to clarify diagnostic criteria and therapeutic management for such a rare condition.