Focal spleen sarcoidosis: clinical and diagnostic characteristics

Purpose of the study. Analysis of literature data on cases of spleen sarcoidosis focal manifestations. Materials and methods. A search was conducted for publications in the PubMed database using the keywords "splenic sarcoidosis", "isolated splenic sarcoidosis" and "primary splenic sarcoidosis" for the period from 1944 to 2024. Articles describing clinical observations of spleen sarcoidosis were selected, where it was possible to reliably determine the presence of focal manifestations of spleen sarcoidosis with a descriptive diagnostic picture, morphological verification, as well as additional information about lesions of other organs. Results. The analysis of these articles revealed 128 cases of spleen sarcoidosis, of which isolated focal spleen sarcoidosis was detected in 41 (32.0 %) cases. Combined sarcoidosis (in which the lesion of the spleen was combined with one or two other localizations or was part of a multiple lesion of the entire organism) accounted for 68.0 % of cases. Sarcoidosis developed synchronously or after surgical treatment of cancer in 22 (17.2 %) cases: synchronously – 12 (54.5 %) cases; in the postoperative period – 10 (45.5 %). An analysis of the identified observations is carried out. The main clinical and radiation characteristics of focal sarcoidosis of the spleen, as well as the most common other localizations in our analysis, are highlighted. Conclusion. Spleen lesions can occur in various clinical situations, ranging from asymptomatic patients to critically ill patients. However, focal formations of the spleen are quite rare, which makes it difficult to collect data from large groups of homogeneous morphological forms for analysis and development of criteria for differential diagnosis, therefore, the presence of a focus in the spleen often causes difficulties for specialists to make a diagnosis. The review identifies the incidence rates of focal spleen sarcoidosis and highlights its main clinical and radiation characteristics. Knowledge of these signs makes it possible to differentiate the disease, especially with an isolated lesion.