---- smear showed clusters of epitheliod histiocytes,admixed with mature and reactive lymphocytes , with caseating zones in the background
!? Granulomatous lesion, with caseating zones
fever -2 months.
significant loss of weight/appetite.
Rapidly progressing Bi-cytopenia
FNAC evidence of granulomatous lesion with caseating zones.
“ SPLENIC TUBERCULOSIS”
--- CAT -1 ATT was started for the patient , fever subsided completely within 2 weeks
--- patient turned up after 2 months
improved body wt
RBC count -3 million/cumm
Platelet count -1.5 lakh/cumm
Rpt. USG abdomen- splenomegaly decreased
- hypoechoeic lesions
- peripancreatic ,portal
nodes not visualised.
FEW CASE REPORTS
Sato T, Mori M, Inamatsu T, Watanabe J, Takahashi T, Esaki Y.
Department of Medicine, Tokyo Metropolitan Geriatric Hospital.
A case of splenic tuberculosis is reported . The patient was a 79-year-old man who was admitted to the Tokyo Metropolitan Geriatric Hospital because of high fever and loss of body weight. Several finger-tip sized superficial lymph nodes were palpable in bilateral inguinal regions. The computed tomogram of the abdomen showed moderate enlargement of the spleen with multiple low density areas and several swollen lymph nodes in the para-aortic region. Although a lymph node of the inguinal region was resected for the pathologic examination, it showed no specific changes. In order to obtain a final diagnosis, laparotomy was performed. The spleen was markedly enlarged and nodular in appearance. No abnormal findings were observed in the other abdominal organs. Splenectomy was carried out. Numerous yellowish nodules, varying from 0.1 to 5 cm in diameter, were observed on the cut surface of the resected spleen (20 x 20 x 8 cm, 700 g). Recently, isolated tuberculosis of the spleen has become very rare. Since 1965, only six cases in five reports can be found in the English, French and German literature. The present case is considered to be one such very rare cases of tuberculosis. Although splenic tuberculosis is rare at the present time, splenic tuberculosis should be included in the differential diagnosis of fever of unknown origin with splenomegaly.
PMID: 1614011 [PubMed - indexed for MEDLINE]Free Article
Isolated Tuberculosis of the Spleen : A Rare Clinical Entity
Citation: S. Dalal, Nityasha, R. S. Dahiya & Prashant : Isolated Tuberculosis of the Spleen: A Rare Clinical Entity . The Internet Journal of Surgery. 2008 Volume 16 Number 1
Adil et al. reported a series of 12 immunocompetent individuals with splenic tuberculosis but all of them had one or more extra site of tuberculous involvement along with the spleen. 5 Generally, these cases present with mild pyrexia and chronic weight loss and are diagnosed during investigational work up for PUO. Rarely, splenic tuberculosis has also been diagnosed incidentally during laparotomy that was carried out for abdominal trauma.
1. Ho PL, Chim CS, Yuen KY. Isolated splenic tuberculosis presenting with pyrexia of unknown origin. Scand J Infect Dis 2000; 32: 700-01. (s)
2. Sambrook J, Frisch EF, Maniatis T. Molecular Cloning. A laboratory manual. Vol. II, 2nd edition. Cold Spring Laboratory Press, 1989. (s)
3. Eisenach KD, Crawford JT, Bates JH. Repetitive DNA sequences as probes for mycobacterium tuberculosis. Journal of Clinical Microbiology 1988; 26: 2240-45. (s)
Indian J Med Res 125, May 2007, pp 669-678
Radiological manifestations of splenic tuberculosis: A 23-patient