Splenic Tuberculosis –A rare case report

Tuberculosis of spleen is an extremely rare clinical entity. It often poses diagnostic difficulties as microbiological confirmation of diagnosis is not easy. We came across a case of middle aged immunocompetent female from good socioeconomic background who presented with weight loss and pain in left hypochondriac region. Ultrasonography of abdomen revealed multiple hypo echoic lesions in the spleen. Splenectomy was performed and sample was sent for histopathological examination and also microbiological analysis. Gross examination of the specimen showed multiple nodules coalescing to form large yellowish white colored mass of firm consistency. Histopathological examination showed large areas of caseation surrounded by multiple granulomas of epitheloid cells and Langhan’s type of giant cells throughout the splenic pulp. PCR was done by using IS6110 primers. This was consistent with the diagnosis of Mycobacterial infection. Mycobacterium tuberculosis grew on culture from the tissue after 5 weeks. No primary focus of infection was detected in the lungs or any other organ. Diagnosis within just a few hours was made possible because of PCR.