Work

Hepatosplenic sarcoidosis

Year: 2026

Type: article

Abstract: RATIONALE: Sarcoidosis is a multisystem granulomatous disease that primarily affects the lungs. Isolated or concurrent hepatosplenic involvement, although not uncommon pathologically, is a rare clinical presentation that poses a significant diagnostic challenge and often mimics malignancy on imaging. PATIENT CONCERNS: A 55-year-old asymptomatic female was admitted after the incidental discovery of pulmonary nodules during a health checkup. DIAGNOSES: Preoperative imaging, including contrast-enhanced computed tomography (CT) and fluorodeoxyglucose positron emission tomography/CT, suggested a high likelihood of splenic malignancy. A definitive diagnosis of hepatosplenic sarcoidosis was established after histopathological examination of both the resected spleen and a concurrent liver biopsy, which revealed noncaseating epithelioid cell granulomas. INTERVENTIONS: The patient underwent laparoscopic splenectomy and intraoperative liver biopsy. OUTCOMES: The patient's postoperative course was uneventful. Given the absence of symptoms and organ dysfunction, the patient was discharged without specific pharmacotherapy and was regularly monitored. To date, follow-up results have been unremarkable. LESSONS: This case underscores that hepatosplenic sarcoidosis can mimic malignancy on advanced imaging studies, such as fluorodeoxyglucose positron emission tomography/CT. Therefore, sarcoidosis should be considered in the differential diagnosis of patients with multifocal splenic lesions and concurrent pulmonary nodules. We hypothesize that earlier incorporation of image-guided lesion biopsy into the diagnostic algorithm may improve diagnostic accuracy and avoid more aggressive surgical procedures in patients with multisystem nodular lesions.

Source: Medicine

DOI: 10.1097/md.0000000000050008

Authors: Weilong Wang, Yongping Luo

Institution: First Affiliated Hospital of Guangdong Pharmaceutical University

Language: English

Topic: Sarcoidosis and Beryllium Toxicity Research

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,950