Unusual Presentation of Tuberculosis as a Splenic Mass

Fatih Dede, Elvin Dogan, Mehmet Demir, Didem Sener, Mehmet Kös, Murat Tad, Erdal Eskioglu
2006 Tohoku journal of experimental medicine  
Tuberculosis is an important health problem in developing countries, with varying clinical presentations depending on the organs/systems involved. Tuberculosis is mostly seen in immuno-compromised individuals, such as those with acquired immune deficiency syndrome or malignancies. Here we report a case of a spleen tuberculoma in a 29-year-old male patient with no known immune deficiency. He first presented with abdominal pain, and subsequent ultrosonographic examination revealed a splenic
more » ... of 10 cm in diameter. A computerized tomography scan of the abdomen confirmed the presence of a solitary, hypodense, septated cystic lesion. Lack of evidence supporting the presence of a splenic infection or a primary/metastatic malignancy prompted explorative surgery where a septated abscess formation was discovered and splenectomy was performed. Histopathological examination revealed granulomatous inflammatory changes with Langerhans-type giant cells, which are consistent with tuberculosis. For a period of two months, antituberculosis therapy with four drugs, isoniazid, rifampicin, pyrazinamide, and ethambutol, was carried out. Pyrazinamide and ethambutol were quitted at the end of two months. Theraphy with isoniazid and rifampicin was planned for an additional 10 months. We would like to call attention to yet another atypical presentation of extrapulmonary tuberculosis. spleen tuberculosis; abdominal tuberculosis; splenic abscess
doi:10.1620/tjem.210.79 pmid:16960348 fatcat:d562tzd6snbihmus7frfmbizvq