avicenna medical research
Volume 4, Numéro 2, Pages 78-81
2025-06-30
A Puzzle In The Spleen: A Case Report Of Isolated Splenic Tuberculosis
Authors : Benhami W . Badache H . Brahimi M . Guendouz H . Rahal L .
Abstract
Background: Isolated splenic tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic regions. Its cystic presentation can mimic other splenic lesions such as hydatid cysts or abscesses, making diagnosis difficult. Case Presentation: We present the case of a 53-year-old woman with six months of left upper quadrant pain. Clinical exam revealed a mild splenomegaly. Blood tests showed leukocytosis and elevated ESR. Imaging revealed multiple cystic splenic lesions, the largest measuring 70 × 35 mm, with peripheral enhancement. Chest X-ray and infectious workup were inconclusive. Due to diagnostic uncertainty, a laparoscopy followed by splenectomy was performed. Histopathology revealed caseating granulomas, confirming isolated splenic tuberculosis. The patient received anti-tuberculous treatment and remained well after two years of follow-up. Conclusion: This case highlights the diagnostic challenge of cystic splenic tuberculosis and underscores the importance of considering it in the differential diagnosis of atypical splenic lesions, especially in endemic settings.
Keywords
Splenic tuberculosis, Cystic spleen, Extrapulmonary TB, Case report
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