Disseminated tuberculosis presenting as hypersplenism

Background: Occurrence of hypersplenism in TB is very rare. We report a case of DTB with hypersplenism presentation. Case presentation: A 23year old man was admitted with complaints of fever, night sweats, anorexia, headache, shortness of breath, early satiety that had started 10 days ago. He had been well until 9 months ago, when early satiety developed for the first time. Physical and ultrasonographic examinations of the abdomen revealed huge splenomegaly. The Results of his blood tests showed pancytopenia Abdominal CT scan revealed a mild hepatomegaly, huge splenomegaly, para-aortic, retroperitoneal, and left inguinal lymphadenopathy. Splenectomy was performed. Pathologic examination of his liver, spleen and lymph node biopsy specimens revealed caseous necrosis and granuloma formation due to TB. After initiating the anti-tuberculosis treatment, all of his signs and symptoms disappeared. At the present time, his general condition is good and he has no any problem Conclusion: Huge splenomegaly and hypersplenism can occur during disseminated tuberculosis. DTB can mimic lymphoma and it must be considered in differential diagnosis of huge spleen.