Citation, DOI, disclosures and article data
Citation:
Iqbal S, Yap J, Glick Y, et al. Splenic sarcoidosis. Reference article, Radiopaedia.org (Accessed on 03 May 2024) https://radiopaedia.org/articles/85582
Splenic sarcoidosis is a non-caseating granulomatous involvement of the spleen, that presents with splenomegaly or multiple splenic nodules.
Clinical features of splenic sarcoidosis include 5,6:
- pain
- anemia
- abdominal pain and discomfort
-
splenomegaly (associated with involvement of the lungs and the liver) 9
On imaging, splenic sarcoidosis mimics an infectious disease or neoplastic process 7,8.
CT
CT demonstrates homogeneous splenomegaly or numerous hypodense nodules, making it difficult to differentiate from metastases in the spleen 1-4,9.
MRI
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T1: splenic lesions are usually hypointense compared to the background parenchyma
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T2: hypointense compared to normal splenic parenchyma
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T1 C+ (Gd): lesions show no enhancement
Treatment and prognosis
Sarcoidosis is treated with corticosteroids. Endoscopic ultrasound-guided biopsy followed by splenectomy is the treatment of choice in cases of non-resolution 3.
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The differential diagnosis for splenic sarcoidosis includes:
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1. Warshauer D, Warshauer. Splenic sarcoidosis. (2007) Seminars in ultrasound, CT, and MR. doi:10.1053/j.sult.2006.10.004 - Pubmed
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2. Gaudemer A, Gaudemer SG, Gaudemer HA, Gaudemer SR, Gaudemer FBD, Gaudemer AJ, Gaudemer. [Splenic sarcoidosis diagnosed by US-guided biopsy: About a case]. (2018) La Revue de medecine interne. doi:10.1016/j.revmed.2017.11.012 - Pubmed
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3. Matsuzawa H, Goto T, Ohshima S, Shibuya T, Sato W, Chiba M, Takahashi K, Minami S, Iijima K. Sarcoidosis with Splenic Involvement Diagnosed with Endoscopic Ultrasound-guided Fine-needle Aspiration. (2020) Internal medicine (Tokyo, Japan). 59 (16): 2077-2081. doi:10.2169/internalmedicine.4512-20 - Pubmed
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4. Wang Y, Wang HY, Wang XH, Wang CH, Wang SK, Wang LQ, Wang. [Splenic sarcoidosis: a case report and review of literature]. (2009) Zhonghua nei ke za zhi. doi: - Pubmed
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5. Priya Wadhwa, Pradeep Vaideeswar. Hepatic, splenic and thyroidal nodular sarcoidosis. (2017) Indian Journal of Pathology and Microbiology. 60 (4): 608. doi:10.4103/IJPM.IJPM_242_17 - Pubmed
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6. Pavlović-Popović, Zora, Zarić, Bojan, Kosjerina, Zdravko, Petrović, Dragana. Splenomegaly in sarcoidosis: Frequency, treatment, prognosis and long-term follow-up. Srpski arhiv za celokupno lekarstvo. 143 (5-6): 279. doi:10.2298/sarh1506279p
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7. Wu JJ, Schiff KR. Sarcoidosis. Am Fam Physician. 2004 Jul 15;70(2):312-22. PMID: 15291090.
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8. Scott GC, Berman JM, Higgins JL Jr. CT patterns of nodular hepatic and splenic sarcoidosis: a review of the literature. J Comput Assist Tomogr. 1997 May-Jun;21(3):369-72. doi: 10.1097/00004728-199705000-00006. PMID: 9135642.
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9. Gezer NS, Başara I, Altay C, Harman M, Rocher L, Karabulut N, Seçil M. Abdominal sarcoidosis: cross-sectional imaging findings. (2015) Diagnostic and interventional radiology (Ankara, Turkey). 21 (2): 111-7. doi:10.5152/dir.2014.14210 - Pubmed
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