Splenic hamartoma is a very rare benign tumor, which is usually found incidentally after splenectomy or autopsy. Although percutaneous needle biopsy can be performed, it carries a high risk of bleeding after the procedure. Therefore, diagnosis is usually made by surgical resection. Herein, we report a case of splenic hamartoma diagnosed by magnetic resonance imaging and contrast-enhanced ultrasonography, which enables visualization of the unique signals of microbubbles in the vessels in real time. Relevant literature is also reviewed.
Adult ; Antigens, CD31/metabolism ; Antigens, CD34/metabolism ; Contrast Media ; Female ; Hamartoma/*diagnosis/pathology/ultrasonography ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Splenic Diseases/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

We report a case of a 61-year-old man who presented with a cough and abdominal discomfort. CT scan of the chest showed two lesions across both lungs, and an abdominal CT scan revealed multiple hypodense lesions in the spleen with cystic lesions on the splenic hilum. Upper gastrointestinal tract endoscopy found creamy yellowish discharge through a fistula between the stomach and splenic hilum. Under fluoroscopic guidance, forceps was inserted into the fistula tract, and forcep biopsy was done. The pathology was consistent with tuberculosis, and a nine-month anti-tuberculosis medication regimen was started. Imaging performed three months after finishing medication indicated improvement of splenic lesions, and the gastro-splenic tract was sealed off. This case is a very rare clinical example of secondary splenic tuberculosis with a gastro-splenic fistula formation in an immunocompetent patient.
Antitubercular Agents/therapeutic use ; Fluoroscopy ; Gastric Fistula/pathology ; Gastroscopy ; Humans ; Male ; Middle Aged ; Spleen/diagnostic imaging/pathology ; Splenic Diseases/*diagnosis/diagnostic imaging/pathology ; Tomography, X-Ray Computed ; Tuberculosis, Splenic/*diagnosis/drug therapy/microbiology ; Ultrasonography

Schistosomiasis is one of the important neglected tropical diseases (NTDs) in Tanzania, particularly in Lake Victoria zone. This baseline survey was a part of the main study of integrated control of schistosomiasis and soil-transmitted helminths (STHs) aimed at describing morbidity patterns due to intestinal schistosomiasis among adults living on Kome Island, Sengerema District, Tanzania. Total 388 adults from Kome Islands (about 50 people from each village) aged between 12 and 85 years, were examined by abdominal ultrasound according to the Niamey protocol. Liver image patterns (LIPs) A and B were considered normal, and C-F as distinct periportal fibrosis (PPF). The overall prevalence of PPF was 42.2%; much higher in males than in females (47.0% in male vs 34.4% in females, P=0.007). Abnormal increase of segmental branch wall thickness (SBWT) and dilated portal vein diameter (PVD) were also more common in males than in females. Hepatosplenomegaly was frequently encountered; 68.1% had left liver lobe hepatomegaly and 55.2% had splenomegaly. Schistosoma mansoni-related morbidity is quite high among adults in this community justifying the implementation of integrated control strategies through mass drug administration, improved water supply (pumped wells), and health education that had already started in the study area.
Abdomen/ultrasonography ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Cross-Sectional Studies ; Female ; Humans ; Islands ; Lakes ; Liver Diseases, Parasitic/diagnosis/*epidemiology/*pathology ; Male ; Middle Aged ; Prevalence ; Schistosomiasis mansoni/diagnosis/*epidemiology/*pathology ; Sex Factors ; Splenic Diseases/diagnosis/*epidemiology/parasitology/*pathology ; Tanzania/epidemiology ; Young Adult