Kurstin Oelschlager Case Presentation 3 Abdomen

Patient History/Clinical Indication: A 78 year old female came into the emergency room. She had been nauseated after eating for three days prior to her hospital visit. An abdominal ultrasound was ordered with attention focused at the area of interest, the gallbladder. Lab/Test Results: No previous tests were recorded. Ultrasound Findings: There were multiple gallstones present. This confirmed the doctor’s suspicion because of the patient’s symptoms. 

The entire abdomen was evaluated and another diagnosis was found incidentally. There are multiple calcified echogenic foci dispersed throughout the entire spleen. The size of the spleen is normal. There are no symptoms to correlate with this finding.

Diagnosis: The spleen contains numerous echogenic foci consistent with splenic granuloma.

Differential Diagnosis: Someone could mistakenly say there are stones visualized within the spleen. The spleen can only have calcifications. There may or may not be shadowing with granulomas. In this case, some of the calcifications have posterior shadowing.

Discussion: Granuloma disease is a mass of immune cells that are working to fight off infection. Histoplasmosis and TB are infections that can lead to a granuloma. Granulomas are focal lesions that are benign neoplasms of the spleen. A granuloma is a rare finding, as well as the other rare neoplasms that can occur in the spleen.