Sarcoidosis is an idiopathic disease characterised by non-caseating granulomas affecting all organ systems. Sarcoidosis most commonly affects the lungs in >90% of cases but can present with extra-pulmonary manifestations; however, isolated splenic sarcoidosis is extremely uncommon. Isolated splenic sarcoidosis proves to be even more rare in a region where tuberculosis is endemic and presents with similar clinical manifestations, which makes diagnosis more challenging. This report describes the case of a young female presenting with non-specific abdominal complaints and clinical splenomegaly with unknown cause, and how the patient was worked up and the challenges that were faced in the diagnostic and therapeutic journey. The value of laparoscopic splenectomy is demonstrated, and the need for a combination of clinical, biochemical, radiological and histological modalities.
McDuling et al. (Wed,) studied this question.