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A 45-year-old woman with a history of mediastinal sarcoidosis, who had been treated with oral corticosteroids six years previously, presented with pain in the left upper quadrant of her abdomen. Computed tomography (CT) revealed heterogeneous splenomegaly with multiple hypovascular nodules (Panel A). After two years of follow-up, the patient still reported abdominal pain, and the spleen had increased in size, from 16 to 20 cm. A laparoscopic splenectomy was performed; a specimen is shown in Panel B. Pathological examination confirmed the presence of sarcoidosis in the spleen and the lymph nodes of the splenic hilum. The patient did well with no further treatment and had no sign of recurrence on thoracoabdominal CT at two years of follow-up.
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