Splenic infarct as a diagnostic pitfall in radiology.
ABSTRACT Follow-up of colorectal carcinoma after therapy is based on symptoms, tumor markers, and imaging studies. Clinicians sometimes face diagnostic dilemmas because of unusual presentations on the imaging modalities coupled with rising serum markers. We report a case of colorectal carcinoma that presented with gastrointestinal symptoms 14 months after completion of treatment. Investigations showed rise in carcinoembryonic antigen (CEA). Suspecting disease recurrence, complete radioimaging workup was performed; the only abnormality detected was a smooth, hypodense area in the posterior third of the spleen on contrast-enhanced computed tomography abdomen. In view of the previous diagnosis of carcinoma colon, the symptoms reported by the patient, the elevated CEA, and the atypical CECT appearance, a diagnosis of splenic metastasis was made. The patient was subjected to splenectomy as a curative treatment. However, the histopathological report revealed it to be a splenic infarct. The present case reemphasizes the limitations of radiological studies in the follow-up of carcinoma colon.
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ABSTRACT: We report a case of a patient with splenic infarction possibly attributable to Mycoplasma pneumoniae infection without accompanying pneumonia. A 24-year-old man was admitted to our hospital with a 7-day history of fever, sore throat, and left upper-quadrant abdominal pain. Chest radiography revealed no active lung lesions; however, abdominal computed tomography showed hepatosplenomegaly with splenic infarction. At the time of admission, the patient's serum IgM titer for M. pneumoniae was 79.7 U/mL (positive titer >70 U/mL). Two weeks later, the serum IgM titer for M. pneumoniae had markedly increased to 3,158.1 U/mL. The patient was treated with azithromycin, and his symptoms began to improve. After 5 weeks, the spleen size decreased, and a scar was observed at the site of the infarct.Journal of Infection and Chemotherapy 02/2012; · 1.55 Impact Factor
- Infection and Chemotherapy. 01/2010; 42(1).