Splenic calcification

Discussion:

Incidental finding of multiple micronodular calcifications in the spleen in a patient with no abdominal complaints. There is no relevant medical history.

Also, there is a peripancreatic lymph node with multiple small calcifications visible on CT.

A plain chest x-ray and CT scan of the chest show subpleural nodularity and pseudoplaque formation and several calcified mediastinal and hilar lymph nodes. There is no evidence of a lung mass, pneumonia or cavitary lung lesion. 

The combination of calcified thoracic and abdominal lymph nodes, pleural thickening and calcification, and multiple calcified lesions in the spleen is most suspicious for silicosis. An alternative diagnosis is splenic granulomatosis due to an old infection, such as tuberculosis or histoplasmosis, although these do not usually cause this exuberant of splenic calcification. 

Histopathological work-up was not performed since the splenic calcifications did not cause any complaints for the patient, and there was no ongoing infection. 

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