Sarcoidosis and Its Splenic Wonder: A Rare Case of Isolated Splenic Sarcoidosis

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology characterized by presence of noncaseating granulomas in the involved organs. The pulmonary interstitium is most commonly affected but extrapulmonary involvement can occur in almost any other organ system. Such an involvement can occur with or without the presence of pulmonary involvement, but isolated extrapulmonary involvement has been noted only in around 10% of cases. Isolated splenomegaly is very rare and an uncommon presentation of sarcoidosis. It is clinically challenging because of the extensive differential diagnosis. Among the many considerations are hematologic malignancies, primary splenic or metastatic tumors, infiltrative disorders, inflammatory disorders, and infections. We hereby discuss an interesting case of a 40-year-old female with isolated splenic sarcoidosis.

Two Cases with Isolated Splenic Sarcoidosis Diagnosed by an Ultrasound-guided Fine-needle Aspiration Biopsy

“…We searched PubMed with the terms "isolated splenic sarcoidosis" and "primary splenic sarcoidosis" for articles published in English until December 31, 2021. We found 14 isolated splenic sarcoidosis cases and summarized their details in Table 3, including our own 2 cases (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Isolated splenic sarcoidosis was more common in women than in men, and abdominal pain and weight loss were frequently identified as subjective symptoms.…”

Sarcoidosis with Splenic Involvement Diagnosed with Endoscopic Ultrasound-guided Fine-needle Aspiration

“…However, in some cases, lesions are found only in a single organ, in which case it is called isolated sarcoidosis. Isolated splenic sarcoidosis has been reported ( 22 ). In these reports, splenectomy and a percutaneous splenic biopsy were performed.…”

Revisiting the Spleen—An Imaging Review of the Common and Uncommon Splenic Pathology

“…While the liver is the most common abdominal organ to be involved along with the spleen, isolated splenic involvement has also been reported. 42 CT shows small size low-density lesions with no significant enhancement. On MRI, randomly distributed small T1 and T2 hypointense nodules with minimal delayed postcontrast enhancement may be seen.…”