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Everything you need to know about Computed Tomography (CT) & CT Scanning

MDCT of the Spleen: Sarcoidosis


Sarcoidosis is a chronic, progressive, multisystem disease of unknown etiology, most commonly affecting the lungs in greater than 90% of patients. Noncaseating granulomas are characteristic of this process and can affect any organ of the body. Typical lung finding include interstitial disease and adenopahty.

Approximately 5-15% of patients have abdominal involvement with the most common presentation being hepatomegaly, splenomegaly and lymphadenopathy. Splenic sarcoidosis can also manifest as multiple 1 - 3 mm low attenuation lesions on contrast enhanced CT. These nodules results from underlying noncaseating granulomas and tend to be innumerable. Similar hypodense lesions occur with metastatic disease (especially melanoma), fungal infections, and lymphoma. With coalescence of these smaller nodules, a diffusely infiltrative appearance with concurrent splenomegaly may result. Concurrent hepatic involvement is frequent with either small low attenuation lesions are hepatomegaly. Other organs, including the skin, eyes, salivary glands, heart, bones, nervous system, and abdomen are affected less frequently.

Scattered splenic calcifications are another presentation of this disease process, which can be identical to the sequela of other granulomatous infections of the spleen. Diagnosis depends on correlation of radiographic findings, clinical symptoms, and associated laboratory abnormalities to distinguish between the multiple disease processes than can mimic the radiographic presentation of sarcoidosis in the spleen.


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