Hepatic and splenic sarcoidosis

Discussion:

This case demonstrates an example of the abdominal manifestations of sarcoidosis. In this case the two organs involved are the liver and spleen.

The CT demonstrates nodular heterogeneity of both organs. In terms of abdominal involvement of sarcoidosis, the liver and spleen are the most commonly involved.

Alternative considerations include metastatic disease (no known primary and none demonstrated on CT), lymphoma (no organomegaly and no nodal enlargement) and opportunistic infection/microabscesses (no history of sepsis or immunocompromise, no recent foreign travel).

The patient underwent a liver biopsy which confirmed the presence of non-caseating granulomatous disease, in keeping with hepatic sarcoidosis.

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