= Abstract =

A Case with Splenic Tuberculosis

Doo-Sun Lee, M.D., Na Hye Myong, M.D.

Section of Pediatric Surgery, Departments of General Surgery and Anatomic

Pathology, College of Medicine, Dankook University, Cheonan, Korea

Splenic tuberculosis is an uncommonly considered diagnosis in clinical practice. This is a case report of splenic tuberculosis in a 13-year-old boy who was seronegative to HIV. He was just well until 7 days prior to this admission when he started to feel epigastric and left subchondral pain. Chest X -ray was not pathological. Abdominal ultrasonography showed slight splenomegaly with multi­ple hypoec:hoi<: nod\\\e-s a\\d abdl)ID.lna\ (,1' uisdosea mu)tip)e irregular hypodense lesions in the spleen. Radiological interpretation suggested the possibility of lym­phoma or metastatic malignancy. Splenectomy was done and the histopathologic­al findings showed extensive chronic: granulomatous inflammation compatible with tuberculosis. Splenic tuberculosis 1l1ust be included in the differential diag­nosis of hypoechoic and hypodense lesions by means of sonography and comput­ed tomography, respectively.

Index Words: Spleen, Tuberculosis.

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Fig. 1. Sonogram shows multiple hypoechoic lesions all over the spleen with slight irregular margins.

Fig. 2. An abdominal CT scan shows multiple hypodense nodules in an enlarged spleen.

Fig. 3. Cut-surface of the spleen shows various sized nodular masses with irregular margins in the entire crgan.

Fig. 4. Exuberant tuberculoid grannulomas destroy almost entire parenchyma, with central caseation necrosis and Langhans-type giant cells (HE, x 100).

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