Sarkoidose der Milz
Extrapulmonale
Sarkoidose bei einem 36jährigen Mann. Befall von Leber und Milz sowie der Lunge. Die Computertomographie axial zeigt multiple hypodense Herde, die primär an ein Malignom denken ließen, zumal die Befunde in der PET-CT stark stoffwechselaktiv waren.
Sarkoidose
der Milz in der Computertomographie: Viele kleine Knötchen in der Milz rechts im Bild.
Extrapulmonale
Sarkoidose bei einem 36jährigen Mann. Befall von Leber und Milz sowie der Lunge. Die Computertomographie coronar zeigt multiple hypodense Herde, die primär an ein Malignom denken ließen.
Computed
tomography of the spleen: how to interpret the hypodense lesion. a, b Transverse contrast-enhanced CT images acquired during the portal-venous phase at different levels in a 55-year-old woman with sarcoidosis affecting the liver (arrowhead) and the spleen (short arrow, long arrows)
Sarcoidosis
(abdominal manifestations) • Sarcoidosis in the abdomen and pelvis - Ganzer Fall bei Radiopaedia
Splenic
sarcoidosis • Sarcoidosis - hepatic and splenic involvement - Ganzer Fall bei Radiopaedia
Sarcoidosis
(abdominal manifestations) • Hepatic and splenic sarcoidosis - Ganzer Fall bei Radiopaedia
Splenic sarcoidosis is a non-caseating granulomatous involvement of the spleen, that presents with splenomegaly or multiple splenic nodules.
Clinical presentation
Clinical features of splenic sarcoidosis include :
- pain
- anemia
- abdominal pain and discomfort
- splenic enlargement (is associated with involvement of the lungs and the liver)
Radiographic features
On imaging, splenic sarcoidosis mimics an infectious disease or neoplastic process .
CT
CT scan demonstrates homogeneous splenomegaly or the existence of numerous hypointense nodules, making it difficult to differentiate from metastases in the spleen .
MRI
- T1: splenic lesions usually hypointense when related to the background parenchyma
- T2: hypointense as compared to normal splenic parenchyma.
- C+ (Gd): lesion shows no enhancement
Treatment and prognosis
Corticosteroids have a role in the treatment of sarcoidosis. Endoscopic ultrasound guided biopsy followed by splenectomy is the treatment of choice in cases of non-resolution .
Differential diagnosis
Differentials of splenic sarcoidosis include:
- tuberculosis
- lymphoma
- metastasis
- abscess
- candidiasis (if the patient is immunosuppressive)
See also
Siehe auch:
- Sarkoidose
- Milzmetastasen
- Lymphom der Milz
- abdominelle Manifestationen der Sarkoidose
- granulomatöse Erkrankungen der Milz
- fokale Milzläsionen und Anomalien
und weiter:
Assoziationen und Differentialdiagnosen zu Sarkoidose der Milz: 
