A Case of Splenic Sarcoidosis Mimicking Malignant Lymphoma Diagnosed by Using Laparoscopic Splenectomy

Abstract

A 69-year-old woman had a history of methotrexate-associated lymphoproliferative disorders treated by quitting methotrexate therapy and had maintained remission since then. A follow-up positron emission tomography detected splenomegaly and abnormal uptake of ¹⁸F-fluorodeoxyglucose in the spleen. Contrast-enhanced computed tomography revealed multiple hypovascular nodules in the spleen. She was referred to our department and was suspected as having a splenic malignant lymphoma. She underwent diagnostic laparoscopic splenectomy. The finding from the historical study represented a non-caseating epithelioid cell granuloma, the specific feature of sarcoidosis. Sarcoidosis often involves spleen. It is difficult to distinguish the splenic lesions of sarcoidosis from malignant lymphoma based on radiological studies only. Laparoscopic splenectomy is less invasive than conventional splenectomy and is useful as a diagnostic procedure.