Medicine · 2026
Hepatosplenic sarcoidosis: A case report and literature review.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод в очереди
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Wang Weilong, Luo Yongping
Аннотация
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.
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.