Isolated splenic sarcoidosis: A case report

Authors

  • Coro Velasco Gametxogoikoetxea Servicio Navarro de Salud-Osasunbidea. Hospital Universitario de Navarra. Servicio de Cardiología. Pamplona. España https://orcid.org/0009-0004-5422-5894
  • Irene Fernández De Los Reyes Servicio Navarro de Salud-Osasunbidea. Hospital Universitario de Navarra. Servicio de Anatomía Patológica. Pamplona. España https://orcid.org/0000-0001-9762-7173
  • Fermín Jiménez Bermejo Servicio Navarro de Salud-Osasunbidea. Hospital Universitario de Navarra. Servicio de Medicina Interna. Pamplona. España

DOI:

https://doi.org/10.23938/ASSN.1131%20

Keywords:

Sarcoidosis, Spleen, Case Reports, Adolescent, Female

Abstract

Isolated splenic sarcoidosis is a rare entity, but clinicians should consider it in patients with compatible clinical features. Its diagnosis is challenging due to the broad differential diagnosis, which includes hematologic and splenic neoplasms, infiltrative and inflammatory disorders, autoimmune diseases, and infections.

We report the case of a 15-year-old female diagnosed with isolated splenic sarcoidosis during hospitalization for fever of unknown origin. Histopathological examination revealed non-caseating granulomas and necrotizing granulomas. The patient showed marked clinical and radiological improvement following corticosteroid therapy, supporting the diagnosis. Despite its atypical presentation, this case highlights the importance of including sarcoidosis in the diagnostic evaluation of prolonged fever, even in young patients without respiratory symptoms.

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References

1. Ma YL, Gal A, Koss M. Reprint of: The pathology of pulmonary sarcoidosis: update. Semin Diagn Pathol. 2018;35(5):324–33. https://doi.org/10.1053/j.semdp.2018.09.001

2. Payne MM, Kaimatchiev V, Loriax M. Pathologic quiz case: Multiple splenic nodules. Arch Pathol Lab Med. 2005;129(3):419–20. https://doi.org/10.5858/2005-129-419-pqcmsn

3. Giovinale M, Fonnesu C, Soriano A, Cerquaglia C, Curigliano V, Verrecchia E, et al. Atypical sarcoidosis: Case reports and review of the literature. Eur Rev Med Pharmacol Sci. 2009;13(SUPPL. 1):37–44. PMID: 19530510.

4. Zia H, Zemon H, Brody F. Laparoscopic splenectomy for isolated sarcoidosis of the spleen. J Laparoendosc Adv Surg Tech - Part A. 2005;15(2):160–2. https://doi.org/10.1089/lap.2005.15.160

5. Villamil-Cajoto I, Lado FL, Van Den Eynde-Collado A, Díaz-Peromingo JA. Abscesos esplénicos. Presentación de nueve casos. Rev Chil Infectol. 2006;23(2):150–4. https://doi.org/10.4067/s0716-10182006000200008

6. Kobayashi K, Einama T, Fujinuma I, Tsunenari T, Miyata Y, Iwasaki T, et al. A rare case of isolated splenic sarcoidosis: A case report and literature review. Mol Clin Oncol. 2021;14(2):1–5. https://doi.org/10.3892/mco.2020.2184

7. Thomas J, Charles D, Kachare N. Isolated splenic sarcoidosis with hypersplenism. J Clin Rheumatol. 2020;26(5):e103–4. https://doi.org/10.1097/RHU.0000000000000966

8. Stoelting A, Esperti S, Balanchivadze N, Piacentino V, Mangano A. Sarcoidosis presenting as massive splenomegaly and severe epistaxis, case report. Ann Med Surg. 2020;54:6–9. https://doi.org/10.1016/j.amsu.2020.03.007

9. Zubair Ullah HM, Surya A, Morley N, Ahmad S. Isolated splenic sarcoidosis: a rare cause of hypercalcaemia in a patient with type 1 diabetes. BMJ Case Rep. 2021;14(10):e245987. https://doi.org/10.1136/bcr-2021-245987

10. Tanimoto A, Shibata M, Honma Y, Morino K, Kusanaga M, Abe S, et al. Two Cases with Isolated Splenic Sarcoidosis Diagnosed by an Ultrasound-guided Fine-needle Aspiration Biopsy. Intern Med. 2023;62(14):2077–83. https://doi.org/10.2169/internalmedicine.0409-22

11. Kyriakos Saad M, El Hajj I, Saikaly E. Sarcoidosis presenting as isolated massive splenomegaly: A case report. Clin Case Reports. 2024;12(8):e9283. https://doi.org/10.1002/ccr3.9283

12. Chon HK, Choi KH, Kim TH. Sarcoidosis with splenic involvement diagnosed via endoscopic ultrasound-guided fine-needle biopsy. Korean J Intern Med. 2018;33(2):449–50. Disponible en: http://dx.doi.org/10.3904/kjim.2016.393

13. Hsu HL. Multiple splenic tumors, hypercalcemia, and acute renal failure. Gastroenterology. 2011;140(1):e7-8. https://doi.org/10.1053/j.gastro.2010.01.062

14. Ruiz Serrato A, Guerrero León MA, Jiménez Martín J, Gómez Lora D. Sarcoidosis esplénica aislada. Reumatol Clin. 2015;11(1):54–5. https://doi.org/10.1016/j.reuma.2014.01.006

15. Jhaveri K, Vakil A, Surani SR. Sarcoidosis and its splenic wonder: A rare case of isolated splenic sarcoidosis. Case Rep Med. 2018;2018:4628439. https://doi.org/10.1155/2018/4628439

16. Crouser ED, Maier LA, Wilson KC, Bonham CA, Morgenthau AS, Patterson KC, et al. Diagnosis and Detection of Sarcoidosis An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2020;201(8):E26–51. https://doi.org/10.1164/rccm.202002-0251ST

17. Brito-Zerón P, Pérez-Álvarez R, Ramos-Casals M. Sarcoidosis. Med Clin (Barc). 2022;159(4):195–204. https://doi.org/10.1016/j.medcli.2022.03.009

18. Judson MA, Costabel U, Drent M, de Athol P, Maier L, Koth L, et al. The WASOG sarcoidosis organ assessment instrument: An update of a previous clinical tool. Sarcoidosis Vasc Diffus Lung Dis. 2014;31(1):19–27. PMID: 24751450

19. Woomer HM, Hamdani TN, Graffeo V, Mustafa B. A Pesky Spleen: A Painful Presentation of Extrapulmonary Sarcoidosis. Cureus. 2023;15(8):e43077. https://doi.org/10.7759/cureus.43077

20. O’Malley DP, George TI, Orazi A, Abbondanzo SL. Benign and Reactive Conditions of Lymph Node and Spleen. American Registry of PathologyWashington, DC; 2009.

21. Souto MM, Tempes BC, Lambert BF, Trindade EN, Trindade MR. Laparoscopic splenectomy for isolated splenic sarcoidosis. JSLS. 2014;18(1):155–9. https://doi.org/10.4293/108680814X13868878212956

22. Aubry MC. Necrotizing granulomatous inflammation: What does it mean if your special stains are negative? Mod Pathol. 2012;25 Suppl 1(S1):S31-8. https://doi.org/10.1038/modpathol.2011.155

23. Binesh F, Halvani H, Navabii H. Systemic sarcoidosis with caseating granuloma. BMJ Case Rep. 2012;2012:bcr0520114278. https://doi.org/10.1136/bcr.05.2011.4278

24. Cervera R, Espinosa G, Ramos-Casals M, Hernández-Rodríguez J, Prieto-González S, Espígol-Frigolé G, et al. Enfermedades autoinmunes sistémicas. 6º edición. Editorial Médica Panamericana S.A. 2021. 294-295.

25. Rahaghi FF, Baughman RP, Saketkoo LA, Sweiss NJ, Barney JB, Birring SS, et al. Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis. Eur Respir Rev. 2020;29(155):190146. https://doi.org/10.1183/16000617.0146-2019

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Published

2025-08-25

How to Cite

1.
Velasco Gametxogoikoetxea C, Fernández De Los Reyes I, Jiménez Bermejo F. Isolated splenic sarcoidosis: A case report. An Sist Sanit Navar [Internet]. 2025 Aug. 25 [cited 2025 Dec. 15];48(2):e1131. Available from: https://recyt.fecyt.es/index.php/ASSN/article/view/115156

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Clinical notes

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