The role of splenectomy in sarcoidosis.

Sarcoid involvement of the spleen with resultant splenomegaly is a fairly common manifestation of this disease.1-8Despite its frequency, splenic sarcoidosis rarely gives rise to objective and subjective manifestations. When present, they may take the form of either anatomical or functional complications. The former include rupture and abdominal discomfort due to increased splenic size.9-12The functional complication of sarcoidosis of the spleen is hypersplenism. Neutropenia, thrombocytopenia, and hemolytic anemia have been reported to occur alone or in various combinations with sarcoidosis.5,8,10,13-40Two cases of hypersplenism treated by splenectomy and with a three-year postoperative follow-up are presented in this paper. The difficulty in obtaining a preoperative diagnosis is well illustrated by these patients. Report of Cases A 41-year-old white man has been previously reported as an unusual instance of portal hypertension and bleeding esophageal varices secondary to sarcoidosis of the liver.19He was first admitted to the Veterans Administration Hospital in