[Multifocal Langerhans-cell granulomatosis with hepatic lesions simulating tumors]. / Granulomatosis multifocal de células de Langerhans con lesiones hepáticas que simulan una afectación tumoral.

Langerhans cells granulomatosis is a rare disease characterized by the clonal proliferation of the Langerhans cell, a cell element pertaining to the mononuclear phagocytes system. Hepatic involvement may be presented, particularly in the multifocal or disseminated form, together with the remaining surrounding organs. Radiologic findings have recently been reported including echographic, computerized tomography and magnetic resonance of the hepatic lesion of the disease. The case of a patient whose initial radiographic study suggested the existence of hepatic metastasis and which was later diagnosed with multifocal granulomatosis of Langerhans cells with hepatic involvement is reported. Radiologic and histologic images are provided and the data reported in the literature concerning this disease are reviewed.

[Asymptomatic chronic intrahepatic cholestasis and multiple hypodense nodules in the liver and the spleen: manifestations of a case of sarcoidosis]. / Colestasis intrahepática crónica asintomática y múltiples nódulos hipodensos en hígado y bazo: manifestaciones de un caso de sarcoidosis.

Sarcoidosis is a systemic granulomatous disease of unknown etiology which may present multiple clinical manifestations. Liver involvement is observed among 21-79% of the cases. Nonetheless, hepatic sarcoidosis is usually asymptomatic and the finding of cholestasis is an infrequent complication. In the last few years, the presence of multiple hypodense nodules in the liver and spleen has been described in 5-15% of these patients following the application of dynamic intravenous techniques in abdominal CT scan. Although the histopathologic study of these nodules suggests that their formation is due to the coalescence of the microscopic granulomas, the cause of this aggregation remains unknown. A case of hepatic sarcoidosis presenting chronic cholestasis and whose abdominal tomographic study with intravenous contrast demonstrated the existence of hypodense lesions in the liver and spleen suggesting malignant disseminated disease is reported.