Images in Clinical Rheumatology
Isolated Splenic Sarcoidosis
Sarcoidosis esplénica aislada
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"documento" => "article" "subdocumento" => "sco" "cita" => "Reumatol Clin. 2015;11:52-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4294 "formatos" => array:3 [ "EPUB" => 56 "HTML" => 3719 "PDF" => 519 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Butterfly Vertebra" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "52" "paginaFinal" => "53" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Vértebra en mariposa" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 997 "Ancho" => 1501 "Tamanyo" => 192210 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lateral X-ray of the thoracic spine showing apparent anterior wedge compression fractures at the D10 level (A, arrow). 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Ángeles Guerrero León, Juan Jiménez Martín, Desirée Gómez Lora" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Antonio" "apellidos" => "Ruiz Serrato" "email" => array:1 [ 0 => "ito.ruizserrato@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M. 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She had presented epigastric and left hypochondrial mild, intermittent pain for years, with a daily frequency and with no relation to meals, having no other associated systemic symptoms. Physical examination was normal. Laboratory studies showed normal acute phase reactants, peripheral blood smear and angiotensin converting enzyme, as well as proteins and autoimmunity, infectious disease (including hydatidosis) and a Mantoux test. Chest and abdomen test, gastrointestinal transit images and electrocardiogram were all normal. An abdominal ultrasound and thoracoabdominal computed tomography showed multiple splenic lesions measuring 7–9<span class="elsevierStyleHsp" style=""></span>mm in diameter, with no spleen enlargement (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The abdominal magnetic resonance showed multiple lesions on the spleen, hypointense in T2 and isointense in T1, with homogeneous and late enhancement upon contrast, with a diameter under 1<span class="elsevierStyleHsp" style=""></span>cm (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Due to the persistence of left hypochondrial pain as well as the diagnostic uncertainty, a laparoscopic splenectomy was programmed. Macroscopically, the spleen presented multiple external and intraparenchymal nodules of a white-fibrous aspect and with a diameter under 1<span class="elsevierStyleHsp" style=""></span>cm; microbiological tests were negative and the lesions were histologically compatible with non-casefying epithelioid granulomas (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). After the uncomplicated splenectomy, the patient remained asymptomatic and with no treatment during follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Sarcoidosis is a granulomatous multisystemic disease of unknown etiology.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> More than 90% of affected patients have pulmonary manifestations at the moment of diagnosis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The extrapulmonary multiorganic affection is frequent, with the spleen involved in 10% in imaging studies and up to 40% in autopsies,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> being asymptomatic only in 5%–7%.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> However, because the affection is exclusively splenic, as was seen in our patient, it is extraordinarily infrequent, and we consider it relevant to present because the correlation between clinical, imaging and histological testing has been seldom reported in previous case publications.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a></p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors state no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0010" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-12-03" "fechaAceptado" => "2014-01-16" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ruiz Serrato A, Guerrero León MÁ, Jiménez Martín J, Gómez Lora D. Sarcoidosis esplénica aislada. Reumatol Clin. 2015;11:54–55.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 633 "Ancho" => 996 "Tamanyo" => 80517 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Abdominal contrast CT scan, which shows multiple spleen lesions with no contrast uptake (arrows).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 671 "Ancho" => 995 "Tamanyo" => 78663 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Abdominal MIR with gadolinium center in T2 showing splenic lesions (arrows).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 660 "Ancho" => 995 "Tamanyo" => 168815 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Microscopic histology of the spleen with non-casefying granulomas (arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.C. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 4 | 9 |
| 2024 October | 62 | 47 | 109 |
| 2024 September | 76 | 27 | 103 |
| 2024 August | 77 | 54 | 131 |
| 2024 July | 93 | 48 | 141 |
| 2024 June | 97 | 27 | 124 |
| 2024 May | 96 | 33 | 129 |
| 2024 April | 78 | 30 | 108 |
| 2024 March | 70 | 35 | 105 |
| 2024 February | 59 | 39 | 98 |
| 2024 January | 72 | 26 | 98 |
| 2023 December | 83 | 23 | 106 |
| 2023 November | 87 | 36 | 123 |
| 2023 October | 84 | 30 | 114 |
| 2023 September | 147 | 41 | 188 |
| 2023 August | 78 | 24 | 102 |
| 2023 July | 92 | 37 | 129 |
| 2023 June | 86 | 27 | 113 |
| 2023 May | 99 | 30 | 129 |
| 2023 April | 56 | 10 | 66 |
| 2023 March | 119 | 36 | 155 |
| 2023 February | 98 | 23 | 121 |
| 2023 January | 97 | 21 | 118 |
| 2022 December | 84 | 53 | 137 |
| 2022 November | 99 | 42 | 141 |
| 2022 October | 116 | 41 | 157 |
| 2022 September | 120 | 28 | 148 |
| 2022 August | 124 | 60 | 184 |
| 2022 July | 108 | 49 | 157 |
| 2022 June | 70 | 39 | 109 |
| 2022 May | 80 | 40 | 120 |
| 2022 April | 60 | 48 | 108 |
| 2022 March | 82 | 58 | 140 |
| 2022 February | 97 | 33 | 130 |
| 2022 January | 83 | 40 | 123 |
| 2021 December | 50 | 40 | 90 |
| 2021 November | 49 | 45 | 94 |
| 2021 October | 88 | 48 | 136 |
| 2021 September | 66 | 36 | 102 |
| 2021 August | 62 | 37 | 99 |
| 2021 July | 81 | 29 | 110 |
| 2021 June | 99 | 42 | 141 |
| 2021 May | 74 | 43 | 117 |
| 2021 April | 87 | 107 | 194 |
| 2021 March | 296 | 33 | 329 |
| 2021 February | 40 | 17 | 57 |
| 2021 January | 40 | 26 | 66 |
| 2020 December | 35 | 23 | 58 |
| 2020 November | 37 | 23 | 60 |
| 2020 October | 35 | 13 | 48 |
| 2020 September | 43 | 33 | 76 |
| 2020 August | 34 | 23 | 57 |
| 2020 July | 36 | 16 | 52 |
| 2020 June | 38 | 26 | 64 |
| 2020 May | 47 | 14 | 61 |
| 2020 April | 24 | 14 | 38 |
| 2020 March | 19 | 8 | 27 |
| 2020 February | 1 | 0 | 1 |
| 2018 December | 1 | 0 | 1 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 69 | 14 | 83 |
| 2018 March | 106 | 14 | 120 |
| 2018 February | 37 | 7 | 44 |
| 2018 January | 53 | 6 | 59 |
| 2017 December | 61 | 4 | 65 |
| 2017 November | 73 | 6 | 79 |
| 2017 October | 57 | 9 | 66 |
| 2017 September | 67 | 10 | 77 |
| 2017 August | 85 | 8 | 93 |
| 2017 July | 73 | 5 | 78 |
| 2017 June | 84 | 9 | 93 |
| 2017 May | 81 | 9 | 90 |
| 2017 April | 67 | 5 | 72 |
| 2017 March | 55 | 16 | 71 |
| 2017 February | 41 | 2 | 43 |
| 2017 January | 46 | 11 | 57 |
| 2016 December | 77 | 18 | 95 |
| 2016 November | 75 | 3 | 78 |
| 2016 October | 110 | 11 | 121 |
| 2016 September | 212 | 14 | 226 |
| 2016 August | 96 | 4 | 100 |
| 2016 July | 54 | 21 | 75 |
| 2016 March | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 1 | 0 | 1 |
| 2015 July | 29 | 12 | 41 |
| 2015 June | 42 | 11 | 53 |
| 2015 May | 81 | 16 | 97 |
| 2015 April | 82 | 13 | 95 |
| 2015 March | 74 | 11 | 85 |
| 2015 February | 72 | 16 | 88 |
| 2015 January | 43 | 17 | 60 |
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