Chakradhar Kalyan, Prasad Shiva, Kumar Sampath, Valiathan Manna
Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.
Department of Pathology, Kasturba Medical College, Manipal, Karnataka, India.
BMJ Case Rep. 2014 May 13;2014:bcr2014203596. doi: 10.1136/bcr-2014-203596.
Splenic tuberculosis is an unusual manifestation of extrapulmonary tuberculosis, especially in immunocompetent hosts. It often poses diagnostic difficulties as microbiological confirmation is not easy. In this case report, we describe a case of pseudocyst of the spleen due to tuberculosis, which is a rare clinical presentation with only one case having been reported previously. A 24-year-old immunocompetent woman presented with pain in the abdomen, vomiting and fever. On evaluation the patient was found to have a cyst arising from the spleen. Splenectomy was performed. Pathological examination of the specimen revealed a pseudocyst with granulomas and giant cells consistent with tuberculosis. Cyst fluid analysis revealed lymphocyte predominance with high adenosine deaminase levels. The patient was started on 6 months of antituberculous therapy postoperatively. On follow-up, the patient was found to have gained weight and showed signs of well-being.
脾结核是肺外结核的一种罕见表现，尤其是在免疫功能正常的宿主中。由于微生物学确诊不易，它常常造成诊断困难。在本病例报告中，我们描述了一例因结核导致的脾假性囊肿，这是一种罕见的临床表现，此前仅报告过一例。一名24岁免疫功能正常的女性出现腹痛、呕吐和发热症状。经评估，发现该患者脾脏有一个囊肿。遂行脾切除术。标本的病理检查显示为一个伴有肉芽肿和巨细胞的假性囊肿，符合结核表现。囊液分析显示淋巴细胞占优势，腺苷脱氨酶水平升高。患者术后开始接受6个月的抗结核治疗。随访时发现患者体重增加，状态良好。
