Splenic tuberculous mass following anti-tuberculosis therapy was misdiagnosed as a splenic tumor: A case report

Figure 1 Abdominal ultrasound showing a cystic mass within the spleen. Orange arrow: A 44 mm × 25 mm hypoechoic area, showing poor internal acoustic transmission and visible by-light bands. No significant blood flow signal detected.

Figure 2 Magnetic resonance imaging sequences: A nodular, mass-like area of abnormal signal intensity measuring approximately 2. 4 cm × 3.5 cm is visible within the spleen. A: T1-weighted imaging shows a heterogeneous, slightly hyperintense signal; B: T2-weighted imaging demonstrates a heterogeneous, hypointense signal with well-defined, smooth margins; C: Diffusion-weighted imaging shows altered diffusion patterns; D-F: No enhancement is observed on contrast-enhanced scans. Orange arrow: Visible lesions.

Figure 3 Postoperative pathology findings. The submitted “partial spleen” specimen demonstrates clearly demarcated areas of splenic tissue necrosis surrounded by a fibrous capsule, with granulomatous formation visible around the necrotic zones. A: Magnification (40 ×); B: Magnification (100 ×). White arrow: Boundary of necrotic areas in spleen tissue; black arrow: Fibrous capsule.

Figure 4 Intraoperative findings: A solid mass was observed within the spleen, characterized by a firm consistency and well-defined borders; the cut surface appeared yellowish-white. A: Holistic view of the specimen; B: The dissected specimen. Orange arrow: The solid mass.