Radiological Findings in a Patient Presenting with Chronic Abdominal Pain as a Secondary Manifestation of Pulmonary Tuberculosis
TJ01-TJ02
Correspondence
Dr. Suresh Vasant Phatak,
Bakul Apartment, Near LAD Square Metro Station, Nagpur-440019, Maharashtra, India.
E-mail: suresh_phatak@yahoo.com
A 32-year-old female patient presented with complaints of loss of appetite, weight loss (8-9 kg), and generalised weakness for three months. The patient also had a history of cough with expectoration for two months accompanied by abdominal pain, particularly on the left-side, and low-grade, intermittent fever for the last two weeks. The Erythrocyte Sedimentation Rate (ESR) was deranged, measuring 25 mm/hr. The Mantoux test was positive with an induration of 17 mm. The sputum study confirmed the diagnosis of tuberculosis by detecting acid-fast bacilli.
On ultrasound, multiple hypoechoic lesions were noted scattered throughout the splenic parenchyma (Table/Fig 1),(Table/Fig 2). They showed no vascularity on colour Doppler and no evidence of calcification (Table/Fig 3). Multiple enlarged lymph nodes were found in the preaortic, para-aortic, peripancreatic, and splenic hilum regions. Computed Tomography (CT) scan demonstrated a tree-in-bud appearance and patchy areas of consolidation in the left lung parenchyma along with multiple subcentimeter lymph nodes. Multiple variable sized hypodense areas (HU +25 to +35) were noted scattered throughout the splenic parenchyma (Table/Fig 4).