Korean J Gastrointest Endosc.  2008 Apr;36(4):238-241.

A Case of Sarcoidosis Presenting as a Rectal Polyp

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. sklee@yuhs.ac
  • 3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Sarcoidosis is a multi-systemic syndrome with an unknown etiology that is characterized by the formation of multiple non-caseating granulomas that disrupts the architecture and function of the tissues. A 58-year-old woman was referred for a skin rash and papules. No specific findings were observed on the initial skin biopsy. On gastroscopy and colonoscopy, gastric erosion and rectal polyp were noted. The rectal biopsy revealed non-caseating granulomas without acid-fast bacilli, indicating a differential diagnosis of Crohn's disease and other granulomatous diseases. A repeat skin biopsy of the papular lesion showed non-caseating granulomas that was consistent with sarcoidosis. The chest x-ray and computed tomography (CT) revealed cardiomegaly without hilar lymphadenopathy. The serum angiotensin converting enzyme level was 122 U/L (normal: 8~52 U/L) with normal liver chemistry as well as normal electrolyte, serum calcium and c-reactive protein levels. Finally, the patient was diagnosed with sarcoidosis with rectal involvement. We report this rare case of sarcoidosis that presented as a rectal polyp.

Keyword

Sarcoidosis; Rectu; lyps

MeSH Terms

Biopsy
C-Reactive Protein
Calcium
Cardiomegaly
Colonoscopy
Crohn Disease
Diagnosis, Differential
Exanthema
Female
Gastroscopy
Granuloma
Humans
Liver
Lymphatic Diseases
Middle Aged
Peptidyl-Dipeptidase A
Polyps
Sarcoidosis
Skin
Thorax
C-Reactive Protein
Calcium
Peptidyl-Dipeptidase A
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