Atypical Sarcoidosis Diagnosed by Massive Splenomegaly

Intern Med. 2020 Mar 1;59(5):641-648. doi: 10.2169/internalmedicine.3646-19. Epub 2019 Oct 31.


We examined a 22-year-old woman who was admitted to our hospital with abdominal distention. At 19 years of age, the patient presented with hepatosplenomegaly. She was examined several times in another hospital; however, the cause was unidentified. Our evaluation showed severe pancytopenia and a spleen 13×24 cm in size. The serum levels of angiotensin-converting enzyme and lysozyme were elevated. She was diagnosed with liver sarcoidosis based on non-caseating epithelioid granuloma in liver biopsy tissue. To improve the symptoms, splenectomy was performed, and her pancytopenia and symptoms improved. Sarcoidosis should be considered in cases of massive splenomegaly.

Keywords: and splenectomy; liver sarcoidosis; massive splenomegaly.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Female
  • Granuloma / complications
  • Humans
  • Muramidase / blood
  • Pancytopenia / complications
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis*
  • Spleen / pathology
  • Splenomegaly / complications*
  • Splenomegaly / surgery
  • Young Adult


  • Muramidase