Sarcoidosis with splenic involvement diagnosed via endoscopic ultrasound-guided fine-needle biopsy

A 48-year-old woman presented with dyspepsia, a 5-kg weight loss, and night sweating for 2 months. She had no underlying disease and denied alcohol consumption or smoking. Her vital signs, physical examination, and laboratory results were unremarkable. Abdominal computed tomography (CT) showed multiple low-density lesions of variable sizes in the spleen, with perisplenic lymph node enlargement (Fig. 1A). Chest CT revealed enlargement of the right upper and bilateral lower paratracheal, para-aortic, aortopulmonary, subcarinal, bilateral hilar, and bilateral interlobar lymph nodes without lung parenchymal abnormalities (Fig. 1B). Abdominal magnetic resonance imaging showed multiple low-signal splenic lesions in all sequences, with hypointensity relative to the background parenchyma (Fig. 1C and 1D). On endoscopic ultrasound (EUS), multiple, ill-defined hypoechoic splenic Sarcoidosis with splenic involvement diagnosed via endoscopic ultrasound-guided fine-needle biopsy