1.Splenic tuberculosis: a report of three cases from Pham Ngoc Thach Hospital
Ho Chi Minh city Medical Association 2005;10(4):206-207
Study on 3 cases of splenic tuberculosis with HIV(-), without pulmonary lesions, treated in Pham Ngoc Thach Hospital of Ho Chi Minh city. Among them, the first one might be a single splenic tuberculosis patient, because there was not any lesion in other areas; the second case was glandular tuberculosis combined with splenic tuberculosis; the third case perhaps was splenic tuberculosis combined with symptoms of tuberculous meningitis occurred 15 days after splenectomy. All 3 cases had major symptoms including mild fever and dull pain in left slope lasting from several months to a year. Ultrasound and abdominal computed tomography scan (CT-scan) showed numerous lesions in the spleen with <2cm size and unspecific decreased dark level with or without big spleen, however, dark increased area should be seen in ultrasound. 2/3 cases of splenectomy with pathological results was splenic tuberculosis, one case was not indicated surgery, making biopsy found a glandular tuberculosis. Splenic tuberculosis treatment with regime of anti-tuberculosis drug during 12 months was suitable
Tuberculosis, Splenic
;
Case Reports
2.Spontaneous Splenic Rupture as a Paradoxical Reaction during Treatment for Splenic Tuberculosis.
Hye Ju YEO ; Soo Yong LEE ; Eunyoung AHN ; Eun Jung KIM ; Dae Gon RHU ; Kyoung Un CHOI ; Seung Eun LEE ; Woo Hyun CHO ; Doosoo JEON ; Yun Seong KIM
Tuberculosis and Respiratory Diseases 2013;75(5):218-221
This report describes a rare case of a patient with splenic tuberculosis (TB) who developed spontaneous splenic rupture after 10 weeks of antituberculous chemotherapy. The patient responded well to the antituberculous regimen prior to the spontaneous splenic rupture. We considered a paradoxical reaction as a cause of the splenic rupture. The patient underwent splenectomy and continuously received initial antituberculous drugs without change. To the best of our knowledge, this is the first report of spontaneous splenic rupture as a paradoxical reaction to antituberculous chemotherapy in an immunocompetent host with splenic TB.
Disease Progression
;
Drug Therapy
;
Humans
;
Splenectomy
;
Splenic Rupture*
;
Tuberculosis
;
Tuberculosis, Splenic*
3.Primary Splenic Tuberculosis Presenting as a Large Solitary Mass.
Ji Hoon KIM ; Myoung Sik HAN ; Gil Hyun KANG ; Seung Mun JUNG ; Yong Pil CHO ; Hyuk Jai JANG ; Yong Ho KIM ; Jin Ho KWAK ; Youn Baik CHOI
Journal of the Korean Surgical Society 2005;69(2):186-188
Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. Although there has been a resurgence of abdominal tuberculosis in immunocompromised patients, which is largely due to the extensive use of immunosuppressive drugs and the increasing incidence of a human immunodeficiency virus infection, splenic tuberculosis is rare, particularly in the immunocompetent patients. Almost all cases of splenic tuberculosis present as multiple hypoechoic foci on sonography or multiple focal hypodense lesions on contrast enhanced computed tomographic scan. To our knowledge, splenic tuberculosis is an extremely rare condition. An 80-year-old man was found to have a large solitary splenic mass mimicking a splenic neoplasm on sonography and contrast enhanced computed tomographic scan. A diagnostic splenectomy revealed a large solitary mass in the spleen, which was consistent with splenic tuberculosis microscopically. We report a rare case of splenic tuberculosis in an elderly man presenting as a large solitary splenic mass on sonography and contrast enhanced computed tomographic scan.
Aged
;
Aged, 80 and over
;
HIV
;
Humans
;
Immunocompromised Host
;
Incidence
;
Spleen
;
Splenectomy
;
Splenic Neoplasms
;
Tuberculosis
;
Tuberculosis, Splenic*
4.Two Cases of Spleen Tuberculosis.
Jeong Hyun PARK ; Hyeck Jae KO ; Hyeok SHIM ; Sei Hoon YANG ; Eun Taik JEONG
Tuberculosis and Respiratory Diseases 2001;50(5):630-635
Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT finding of splenic tuberculosis are multiple, well-defined, roung or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One paitient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.
Abdomen
;
Communicable Diseases
;
Humans
;
Inflammation
;
Lymphatic Diseases
;
Mediastinum
;
Mycobacterium tuberculosis
;
Pathology
;
Pleural Effusion
;
Spleen*
;
Splenectomy
;
Tuberculosis*
;
Tuberculosis, Miliary
;
Tuberculosis, Splenic
5.Rituximab for Rheumatoid Arthritis Following TNF-alpha Inhibitor Associated Splenic Tuberculosis.
Jin Su KIM ; Jung Ran CHOI ; Jung Soo SONG ; Kyung Joon KIM ; Youn Su PARK ; Jun Hwan CHO ; Min Jee HAN ; Sang Tae CHOI
Journal of Rheumatic Diseases 2013;20(2):108-112
One of the most important adverse effects of a tumor necrosis factor (TNF)-alpha inhibitor is the reactivation of tuberculosis. Most of them occur in the lung, but sometimes they can be found in other organs. Moreover, the proper management of active rheumatoid arthritis (RA) in patients with anti-TNF-alpha associated tuberculosis is still in debate. We present the case of a seropositive RA patient who showed good response with rituximab, an anti-CD20 monoclonal antibody, after developing splenic tuberuculosis, following treatment with TNF-alpha inhibitor. Confirming a diagnosis of splenic tuberculosis is difficult and can be delayed due to its nonspecific symptoms and rare occurrence. This case suggests that splenic tuberculosis should be doubted in RA patients treated with TNF-alpha inhibitor, and that rituximab may be considered as an alternative treatment option in RA patients with anti-TNF-alpha associated tuberculosis.
Antibodies, Monoclonal, Murine-Derived
;
Arthritis, Rheumatoid
;
Humans
;
Lung
;
Tuberculosis
;
Tuberculosis, Splenic
;
Tumor Necrosis Factor-alpha
;
Rituximab
6.A Case of Tuberculous Splenic Abscess.
sOON jU JEONG ; Jung Chul KIM ; Chol Kyoon CHO ; Hyun Jong KIM
Journal of the Korean Surgical Society 2001;61(3):339-343
Splenic abscesses in the tropics assume importance because of their unusual aetiology. They may be secondary or primary. Splenic tuberculosis is rare and a delay in diagnosis is common. The authors report a patient with splenic and mesenteric tuberculosis who was admitted to the hospital because of an abdominal cyst incidentally detected on ultrasonogram during prenatal fetal monitoring in the Department of Obsterics. The patient had already been treated with anti-tuberulous drugs for the previous 18 months after being diagnosed as tuberulous pleuritis. Abdominal sonography and computerized tomography revealed the presence of multiple hypoechoic and hypodense splenic lesions and mesenteric cysts. Diagnostic splenectomy and excision of the mesenteric cysts revealed multiple necrotic masses in the spleen, consistent with the microscopic findings of caseating granulomatous inflammation. Following splenectomy, the patient was also treated with an anti-tuberculosis regimen with no recurrence of symptoms.
Abscess*
;
Diagnosis
;
Fetal Monitoring
;
Humans
;
Inflammation
;
Mesenteric Cyst
;
Pleurisy
;
Recurrence
;
Spleen
;
Splenectomy
;
Tuberculosis
;
Tuberculosis, Splenic
;
Ultrasonography
7.Splenic Tuberculosis: Two Cases Report.
Seong LEE ; Il Young PARK ; Chang Gyun HONG ; Seung Hye CHOI ; Jong Kyung PARK ; Sang Seob YOON ; Kee Ok MIN
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2001;5(2):125-130
Splenic tubeculosis is a very rare disorder, few reported in the literature. Here we report 2 patients with splenic tuberculosis, who were admitted to our hospital due to unknown origin fever. Computerized tomography and abdominal ultrasonography revealed the presence of multiple hypodense and anechoic or hypoechoic lesions in spleen. Ultrasonography-guided percutaneous aspiration was suitable in our cases. All laboratory test showed non-specific findings. Splenectomy was performed. After splenectomy they were treated with appropriate antibiotics. They were discharged with a good general condition without any complications.
Anti-Bacterial Agents
;
Fever of Unknown Origin
;
Humans
;
Spleen
;
Splenectomy
;
Tuberculosis
;
Tuberculosis, Splenic*
;
Ultrasonography
8.Primary Hepatosplenic Tuberculosis in an Immunocompetent Adult and Domestic Literature Review.
Se Yoon PARK ; Eun Jung LEE ; Tae Hyong KIM ; Jae Young JANG ; Min Huok JEON ; Eun Ju CHOO ; So Young JIN
Soonchunhyang Medical Science 2012;18(2):134-137
Hepatic or splenic involvement of tuberculosis without other disseminated lesions is a very uncommon form of extrapulmonary tuberculosis, especially in an immunocompetent adult. We report a case of a 25 year-old-man who developed primary hepatosplenic tuberculosis not associated with the lung or other distant organs. He was initially diagnosed with esophageal candidiasis in local clinic. A computed tomographic scan of the abdomen showed hepatosplenomegaly and multiple microabscesses in the spleen. Our initial diagnosis, based on the clinical feature and radiologic findings, was hepatosplenic candidiasis. However, histopathology of the liver specimens revealed chronic granuloma with central caseous necrosis, strongly suggestive of tuberculosis. Although rare, splenic tuberculosis should be considered in the differential diagnosis of splenic abscess, especially in countries where tuberculosis is endemic.
Abdomen
;
Abscess
;
Adult
;
Candidiasis
;
Diagnosis, Differential
;
Granuloma
;
Humans
;
Liver
;
Lung
;
Necrosis
;
Spleen
;
Tuberculosis
;
Tuberculosis, Hepatic
;
Tuberculosis, Splenic
9.A case of accessory splenic tuberculosis mimicking a distal pancreatic tumor.
Seong Hu PARK ; Dong Gun LEE ; Jeong Mun CHOI ; Jong Hun SEO ; Mi Jin YANG ; Dae Kwan LIM ; Sang Ho LEE
Korean Journal of Medicine 2010;79(1):53-56
Abdominal tuberculosis usually affects the gastrointestinal tract, peritoneum, lymph nodes, liver or spleen. Tuberculosis of the spleen is uncommon, except when associated with miliary dissemination. We report a case of a 33-year-old man with tuberculosis of the accessory spleen, which was originally suspected to be a distal pancreatic tumor. He was admitted with a history of left upper quadrant abdominal pain for 3 months. Computed tomography imaging of the abdomen revealed a 4.5 cm sized poorly defined hypodense mass in the distal pancreas and showed multiple focal hypodense lesions in the enlarged spleen. We performed distal pancreatectomy and splenectomy under the preoperative expectation of a distal pancreatic tumor. Microscopic examination of the specimens revealed accessory splenic tuberculosis associated with splenic tuberculosis. Following this, he was treated with appropriate antituberculosis drugs and was discharged without any complications.
Abdomen
;
Abdominal Pain
;
Adult
;
Gastrointestinal Tract
;
Humans
;
Liver
;
Lymph Nodes
;
Pancreas
;
Pancreatectomy
;
Peritoneum
;
Spleen
;
Splenectomy
;
Splenomegaly
;
Tuberculosis
;
Tuberculosis, Splenic
10.A Case of Mass-Forming Splenic Tuberculosis: MRI Findings with Emphasis of Diffusion-Weighted Imaging Characteristics.
Jihe LIM ; Jeong Sik YU ; Soon Won HONG ; Jae Joon CHUNG ; Joo Hee KIM ; Ki Whang KIM
Journal of Korean Medical Science 2011;26(3):457-460
Tuberculosis remains one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. The diagnosis and treatment of extrapulmonary tuberculosis involving the abdomen is still complicated owing to vague or non-specific clinical features. Although rare, isolated splenic involvement is one of the important manifestations of extrapulmonary tuberculosis, and imaging suspicion of the disease is essential. We report a case of surgically confirmed mass-forming splenic tuberculosis showing a layered pattern consisting of caseous necrosis with profound restriction of water molecules surrounded by an irregular rind of granulation tissue with less diffusion restriction on diffusion-weighted magnetic resonance imaging (DWI). In the differential diagnosis of neoplastic or non-neoplastic mass-forming lesions involving the spleen, this unique DWI feature could be helpful in characterizing splenic tuberculosis. The patient has been in clinically disease free status for nearly 20 months after splenectomy.
Diffusion Magnetic Resonance Imaging/*methods
;
Female
;
Humans
;
Middle Aged
;
Necrosis
;
Splenectomy
;
Tuberculosis, Splenic/*pathology