Splenic tuberculomas with tubercular psoas abscess

Case contributed by Simran Singh
Diagnosis probable

Presentation

Swelling in the loin region. Previously treated for tuberculosis for 6 months.

Patient Data

Age: 35 years
Gender: Male

Loculated collection along both psoas muscles with multiple tiny calcifications in splenic parenchyma.

Case Discussion

Splenic calcifications usually represent sequelae of previous acute lesions and are a non-specific finding. The causes are numerous, including infections, such as histoplasmosis (Histoplasma capsulatum), tuberculosis, brucellosis (Brucella abortus), candidiasis, Pneumocystis jiroveci and sickle cell disease.

Single or smaller numbers of calcified lesions can also be seen following trauma and ischemia/infarction.

Calcification can also be associated with splenic hemangiomas and cysts. Rarely, splenic calcification can be associated with non-Hodgkin lymphoma of the spleen.

Thorotrast (thorium dioxide), an alpha particle-emitting contrast medium used until 1960, can also cause radiopacification of the spleen although in a more diffuse, higher intensity appearance than that seen here 1.

Special thanks to: Dr Nagaraj Murthy

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