Splenic sarcoidosis

Last revised by Joshua Yap on 7 Sep 2022

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 demonstrates homogeneous splenomegaly or numerous hypodense nodules, making it difficult to differentiate from metastases in the spleen 1-4,9.

  • T1: splenic lesions are usually hypointense compared to the background parenchyma
  • T2: hypointense compared to normal splenic parenchyma
  • T1 C+ (Gd): lesions show no enhancement

Sarcoidosis is treated with corticosteroids. Endoscopic ultrasound-guided biopsy followed by splenectomy is the treatment of choice in cases of non-resolution 3.

The differential diagnosis for splenic sarcoidosis includes:

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