Ozgüroğlu M, Celik A F, Demir G, Aki H, Demirelli F, Mandel N, Büyükünal E, Serdengeçti S, Berkarda B
Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University, Turkey.
J Clin Gastroenterol. 1999 Jul;29(1):96-8. doi: 10.1097/00004836-199907000-00024.
Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. The authors report a case of splenic tuberculosis mimicking metastatic tumor on computed tomography in a 60-year-old woman who had been treated with combination chemotherapy for nasal angiocentric lymphoma. Diagnostic splenectomy revealed multiple necrotic masses in the spleen, which were consistent with caseating granulomas microscopically. Diagnosis was confirmed by positive cultures in Lowenstein medium, which grew typical Mycobacterium tuberculosis organisms. Following splenectomy, the patient was also treated with a triple-drug antituberculosis regimen with no recurrence of her symptoms.
当结核病出现在不常见的肺外部位时，可能难以诊断。作者报告了一例60岁女性的脾结核病例，该患者曾接受鼻血管中心性淋巴瘤联合化疗，其计算机断层扫描表现类似转移性肿瘤。诊断性脾切除术显示脾脏有多个坏死性肿块，显微镜下与干酪样肉芽肿一致。通过在罗氏培养基上培养阳性确诊，培养出了典型的结核分枝杆菌。脾切除术后，患者还接受了三联抗结核治疗方案，症状未再复发。
