Sarcoidosis in the abdomen and pelvis

Case contributed by Michael P Hartung
Diagnosis almost certain



Patient Data

Age: 55
Gender: Female

Mediastinal, hilar, left axillary adenopathy. 

Mosaic attenuation of lung parenchyma without other acute or chronic findings. 


Numerous splenic lesions. 

Retroperitoneal, pelvic, and inguinal adenopathy. 

Case Discussion

Patient had biopsy proven sarcoidosis following biopsy of axillary lymph nodes. 

This case highlights several non-pulmonary manifestations of disease, which are:

  • Adenopathy in the chest, axilla, retroperitoneum, pelvis and inguinal regions
  • Hepatomegaly
  • Numerous splenic lesions

The major mimic for this disease would be lymphoma. Aside from the biopsy, the pattern of splenic lesions would be uncommon for lymphoma (usually enlargement or few lesions) and is more suggestive of sarcoid. If you were concerned, ultrasound-guided biopsy of the inguinal lymph nodes would provide a safe target. 

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