Velasco Gametxogoikoetxea Coro, Fernández De Los Reyes Irene, Jiménez Bermejo Fermín
Servicio Navarro de Salud-Osasunbidea. Hospital Universitario de Navarra. Servicio de Cardiología. Pamplona. España.
Servicio Navarro de Salud-Osasunbidea. Hospital Universitario de Navarra. Servicio de Anatomía Patológica. Pamplona. España.
An Sist Sanit Navar. 2025 Aug 25;48(2):e1131. doi: 10.23938/ASSN.1131.
Isolated splenic sarcoidosis is a rare entity, but clinicians should consider it in patients with compatible clinical features. Its diagnosis is challenging due to the broad differential diagnosis, which includes hematologic and splenic neoplasms, infiltrative and inflammatory disorders, autoimmune diseases, and infections. We report the case of a 15-year-old female diagnosed with isolated splenic sarcoidosis during hospitalization for fever of unknown origin. Histopathological examination revealed non-caseating granulomas and necrotizing granulomas. The patient showed marked clinical and radiological improvement following corticosteroid therapy, supporting the diagnosis. Despite its atypical presentation, this case highlights the importance of including sarcoidosis in the diagnostic evaluation of prolonged fever, even in young patients without respiratory symptoms.
孤立性脾结节病是一种罕见的疾病，但临床医生在具有相符临床特征的患者中应考虑到该病。由于鉴别诊断范围广泛，包括血液系统和脾脏肿瘤、浸润性和炎症性疾病、自身免疫性疾病及感染等，其诊断具有挑战性。我们报告一例15岁女性患者，因不明原因发热住院期间被诊断为孤立性脾结节病。组织病理学检查显示非干酪样肉芽肿和坏死性肉芽肿。患者在接受糖皮质激素治疗后临床和影像学表现显著改善，支持该诊断。尽管该病例表现不典型，但它凸显了在长期发热的诊断评估中纳入结节病的重要性，即使是没有呼吸道症状的年轻患者。
