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Sarcoidosis hepática y esplénica sin linfadenopatía: una presentación multisistémica atípica
Inês Fiúza M Rua1, João Rodrigues2, Sérgio Cabaço1
1Internal Medicine, Unidade Local de Saúde São José, Lisbon, PRT.
Cureus
|February 17, 2026
Resumen
Este estudio de caso analiza la sarcoidosis hepática, una forma rara de sarcoidosis que afecta el hígado y el bazo sin ganglios linfáticos agrandados. Enfatiza los desafíos diagnósticos de esta presentación atípica.
Área de la Ciencia:
- Medicina Interna
- Patología
- Hepatología
Sus antecedentes:
- La sarcoidosis es una enfermedad granulomatosa multisistémica.
- La afectación hepatiesplénica puede ocurrir, pero los casos aislados sin linfadenopatía son infrecuentes.
- Las presentaciones atípicas plantean desafíos diagnósticos.
Objetivo del estudio:
- Presentar un caso de sarcoidosis con hepatoesplenomegalia aislada y sin linfadenopatía.
- Destacar las dificultades diagnósticas en casos de sarcoidosis atípica.
- Enfatizar la importancia de considerar la sarcoidosis en los diagnósticos diferenciales.
Principales métodos:
- Informe de caso de una mujer de 66 años.
- Presentación clínica: hepatoesplenomegalia crónica, citopenias, enzimas colestásicas, cambios pulmonares.
- Exclusión de causas infecciosas, autoinmunes y hematológicas.
- Biopsia hepática que confirma granulomas no caseificantes.
Principales resultados:
- Diagnóstico de sarcoidosis hepática confirmado por biopsia hepática.
- Ausencia de linfadenopatía.
- Exclusión de otras enfermedades granulomatosas.
Conclusiones:
- La hepatoesplenomegalia aislada sin linfadenopatía puede ser una presentación de la sarcoidosis.
- El estudio diagnóstico de las enfermedades granulomatosas debe considerar la sarcoidosis incluso en escenarios atípicos.
- El reconocimiento temprano es crucial para un manejo adecuado.
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