Splenic Granulomas: Causes, Symptoms & Treatment

Splenic granulomas, characterized as focal microscopic aggregations of immune cells, often present diagnostic challenges in internal medicine, demanding comprehensive evaluation to discern the underlying etiology. The differential diagnosis of splenic granulomas includes infectious diseases like tuberculosis, a condition frequently investigated by organizations such as the Centers for Disease Control and Prevention (CDC) utilizing advanced diagnostic tools, including polymerase chain reaction (PCR). Histopathology, a critical tool in the diagnosis of splenic granulomas, aids pathologists, such as Dr. Juan Rosai, a notable figure in the field, to differentiate between various granulomatous diseases based on their morphological characteristics. The geographical distribution of certain fungal infections, such as histoplasmosis endemic to the Ohio River Valley, necessitates consideration of regional factors in the assessment of splenic granulomas.

Image taken from the YouTube channel Unified Medicare , from the video titled Splenic granuloma | Cholelithiasis .

Unveiling the Mystery of Splenic Granulomas

Splenic granulomas are defined as localized, organized collections of immune cells within the spleen. These microscopic aggregates represent the body's response to a variety of stimuli, signaling an underlying process that warrants careful evaluation. They are not a disease in themselves, but rather a manifestation of another condition.

A Spectrum of Potential Causes

The etiological landscape of splenic granulomas is remarkably diverse. Identifying the underlying cause is crucial for appropriate management.

This includes:

• Infections: A wide array of infectious agents, both bacterial and fungal, can trigger granuloma formation.
• Inflammatory Conditions: Systemic inflammatory diseases often involve the spleen, leading to the development of granulomas.
• Malignancies: Certain cancers, particularly lymphomas, can manifest with splenic granulomas.

The Clinical Significance: More Than Just an Incidental Finding

Splenic granulomas are frequently discovered incidentally during imaging performed for unrelated reasons. This highlights the importance of vigilance even when symptoms are absent.

However, the presence of splenic granulomas should not be dismissed as insignificant. They can be indicative of an underlying systemic disease, ranging from treatable infections to serious malignancies.

A thorough investigation is therefore necessary to determine the etiology of the granulomas and guide appropriate clinical management. Failure to do so could result in delayed diagnosis and treatment of a potentially life-threatening condition.

Etiological Deep Dive: Exploring the Roots of Splenic Granulomas

Splenic granulomas, while identifiable as distinct entities, often serve as clues pointing towards a broader, underlying systemic condition. Understanding the potential causes is paramount in guiding appropriate diagnostic and therapeutic strategies. This section will dissect the diverse range of etiological factors that can precipitate the formation of these splenic lesions, ranging from infectious agents to inflammatory processes and even malignancies.

Infectious Etiologies: When the Spleen Fights Back Against Invaders

Infections stand as a significant category of culprits in the development of splenic granulomas. The spleen, being a crucial component of the immune system, actively filters pathogens from the bloodstream. When confronted with persistent or overwhelming infections, the spleen may mount a granulomatous response, attempting to contain and eradicate the offending agent.

Tuberculosis (TB): A Classic Granulomatous Disease

Tuberculosis, caused by Mycobacterium tuberculosis, remains a leading cause of granuloma formation worldwide. Splenic involvement in TB typically manifests as caseating granulomas, characterized by a central core of necrotic, cheese-like material. This caseous necrosis is a hallmark of TB infection, reflecting the intense immune response and tissue damage induced by the bacteria.

Fungal Infections: Histoplasmosis and Beyond

Fungal infections, such as histoplasmosis, can also trigger splenic granulomas. Histoplasmosis, endemic in certain regions like the Mississippi and Ohio River valleys, is caused by the fungus Histoplasma capsulatum. Inhaled fungal spores disseminate throughout the body, potentially leading to granuloma formation in the spleen and other organs.

Vector-borne and Zoonotic Infections

Cat-scratch disease, caused by the bacteria Bartonella henselae, is a zoonotic infection transmitted through cat scratches or bites. While typically self-limiting, it can occasionally result in splenic granulomas.

Schistosomiasis, a parasitic infection prevalent in tropical regions, can also involve the spleen, leading to granuloma formation around trapped Schistosoma eggs. Leishmaniasis, another parasitic infection transmitted by sandflies, is characterized by granulomatous inflammation in the spleen, liver, and bone marrow.

Viral Culprits: EBV and CMV

Viral infections, such as Epstein-Barr Virus (EBV) and Cytomegalovirus (CMV), can also contribute to splenic granuloma formation, particularly in immunocompromised individuals. EBV, known for causing infectious mononucleosis, can trigger a granulomatous response in the spleen as part of its systemic effects. CMV, a common opportunistic infection, can also lead to splenic granulomas, especially in individuals with weakened immune systems.

Inflammatory and Autoimmune Diseases: When the Body Attacks Itself

Beyond infections, inflammatory and autoimmune diseases represent another major category of etiologies for splenic granulomas. In these conditions, the body's immune system mistakenly targets its own tissues, leading to chronic inflammation and granuloma formation in various organs, including the spleen.

Sarcoidosis: A Systemic Granulomatous Disorder

Sarcoidosis is a systemic disease characterized by the formation of non-caseating granulomas in multiple organs. The non-caseating granulomas of sarcoidosis lack the central necrosis seen in TB, representing a different type of immune response. The spleen is frequently involved in sarcoidosis, and splenic granulomas are often detected incidentally during imaging studies.

Crohn's Disease

Crohn's disease, a chronic inflammatory bowel disease, can also manifest with splenic involvement, albeit less frequently than sarcoidosis. The exact mechanism of splenic involvement in Crohn's disease is not fully understood but may be related to systemic inflammation and immune dysregulation.

Granulomatosis with Polyangiitis (GPA)

Granulomatosis with Polyangiitis (GPA), previously known as Wegener's granulomatosis, is a systemic vasculitis characterized by inflammation of blood vessels and the formation of granulomas. While GPA primarily affects the respiratory tract and kidneys, the spleen can also be involved, leading to granuloma formation.

Malignancies: The Spleen as a Site of Tumor Involvement

Although less common than infectious or inflammatory etiologies, malignancies can also give rise to splenic granulomas. In these cases, the granulomas may represent an immune response to the tumor or direct infiltration of the spleen by malignant cells.

Lymphoma

Lymphoma, particularly T-cell lymphomas, can be associated with splenic granulomas. The granulomas may reflect an immune response to the lymphoma cells or, in some cases, represent actual lymphoma involvement of the spleen. Hodgkin's and Non-Hodgkin's lymphomas are both possible culprits.

Leukemia

Chronic Lymphocytic Leukemia (CLL) is a type of leukemia that can infiltrate the spleen, leading to splenomegaly and, occasionally, granuloma formation.

Other Conditions: A Miscellaneous Category

Beyond the major categories of infectious, inflammatory, and malignant etiologies, a variety of other conditions can occasionally lead to splenic granulomas.

Drug-Induced Granulomas

Drug-induced granulomas can occur as an adverse reaction to certain medications. These granulomas are typically non-caseating and may resolve upon discontinuation of the offending drug.

Splenic Abscess

A splenic abscess is a localized infection within the spleen that can also trigger granuloma formation.

By systematically considering these diverse etiological factors, clinicians can effectively approach the diagnosis and management of patients presenting with splenic granulomas, tailoring their investigations and treatment strategies to address the underlying cause.

Clinical Manifestations: Recognizing the Signs and Symptoms

Splenic granulomas, while identifiable as distinct entities, often serve as clues pointing towards a broader, underlying systemic condition. Understanding the potential causes is paramount in guiding appropriate diagnostic and therapeutic strategies. This section will dissect the clinical presentations associated with splenic granulomas, encompassing physical findings and systemic symptoms, to facilitate a deeper understanding of how these granulomas manifest in patients.

Splenomegaly: A Palpable Clue

Splenomegaly, or enlargement of the spleen, represents one of the most frequently encountered physical findings in individuals with splenic granulomas. The degree of splenic enlargement can vary considerably, ranging from barely palpable to significantly extending into the abdominal cavity.

This enlargement occurs as the spleen actively responds to the underlying etiology, whether it be an infection, inflammatory process, or malignant infiltration. The detection of splenomegaly during a physical examination should prompt further investigation to determine the root cause.

Abdominal Pain: A Consequence of Enlargement and Inflammation

Abdominal pain, while not always present, can be a significant symptom associated with splenic granulomas. The pain can arise from several mechanisms:

• Capsular Distention: As the spleen enlarges, it stretches the splenic capsule, which is rich in nerve endings, leading to a sensation of fullness or pain in the left upper quadrant of the abdomen.

• Inflammation: The inflammatory processes associated with granuloma formation can directly irritate the splenic tissue and surrounding structures, contributing to localized pain.

• Splenic Infarction: In some instances, the granulomas can compromise blood flow to the spleen, leading to infarction and acute, severe abdominal pain.

The nature and intensity of the pain can provide clues as to the underlying cause.

Systemic Symptoms: Unveiling the Bigger Picture

In addition to localized symptoms, splenic granulomas can often manifest with a range of systemic symptoms that reflect the broader impact of the underlying disease process.

Fever: A Hallmark of Infectious Etiologies

Fever is a common systemic symptom, particularly when the splenic granulomas are caused by an infectious agent. The fever can be intermittent or persistent, and its pattern may offer insights into the specific pathogen involved. It's crucial to investigate infectious causes in patients presenting with fever and splenic granulomas.

Night Sweats: A Red Flag for Infection or Lymphoma

Night sweats, characterized by drenching episodes of perspiration during sleep, can be a particularly concerning symptom. While night sweats can occur in various conditions, their presence in conjunction with splenic granulomas should raise suspicion for underlying infection (e.g., tuberculosis) or lymphoma.

Lymphadenopathy: Indicating Systemic Involvement

Lymphadenopathy, or enlarged lymph nodes, suggests that the disease process is not confined to the spleen but has spread to the lymphatic system. The location and characteristics of the enlarged lymph nodes can provide further clues as to the underlying etiology.

For example, widespread lymphadenopathy may be seen in lymphoma or systemic infections.

Cytopenias: Impact on Blood Cell Counts

Cytopenias, which refer to reductions in one or more blood cell types (red blood cells, white blood cells, or platelets), can occur as a result of splenic granulomas.

The spleen plays a role in filtering and removing old or damaged blood cells, and when it is affected by granulomas, its function can be disrupted. This disruption can lead to:

• Anemia: A decrease in red blood cells, leading to fatigue and weakness.
• Leukopenia: A decrease in white blood cells, increasing susceptibility to infections.
• Thrombocytopenia: A decrease in platelets, increasing the risk of bleeding.

The specific type and severity of cytopenia can provide valuable information about the underlying cause and the extent of splenic involvement.

Diagnostic Arsenal: Tools and Techniques for Identification

Splenic granulomas, while identifiable as distinct entities, often serve as clues pointing towards a broader, underlying systemic condition. Understanding the potential causes is paramount in guiding appropriate diagnostic and therapeutic strategies. This section will dissect the clinical tools available to physicians in identifying and characterizing splenic granulomas, ranging from sophisticated imaging techniques to invasive biopsy procedures. Each modality offers unique advantages and limitations, contributing crucial pieces to the diagnostic puzzle.

Imaging Modalities: A Visual Investigation

Imaging plays a crucial role in the initial detection and characterization of splenic granulomas. While not always specific, certain imaging features can suggest particular etiologies and guide subsequent investigations.

Computed Tomography (CT) Scan

CT scanning is frequently the initial imaging modality employed due to its accessibility and ability to provide a comprehensive view of the abdomen. It can reveal the presence of splenomegaly, focal lesions within the spleen, and associated lymphadenopathy.

However, CT findings alone are rarely diagnostic of splenic granulomas, necessitating further investigation.

Magnetic Resonance Imaging (MRI)

MRI offers superior soft tissue contrast compared to CT, allowing for a more detailed assessment of splenic lesions. The signal intensity characteristics of granulomas on different MRI sequences can sometimes provide clues about their composition and age.

For example, gadolinium enhancement patterns may differentiate between active inflammation and fibrotic changes.

Ultrasound

Ultrasound is often used as an initial assessment due to its non-invasive nature and lack of radiation exposure. It can detect splenomegaly and some splenic lesions.

However, it is less sensitive than CT or MRI for characterizing small or deep-seated granulomas.

Positron Emission Tomography (PET) Scan

PET scans, particularly when combined with CT (PET/CT), can be valuable in detecting metabolically active lesions. This is especially useful in evaluating for malignancy or infectious etiologies.

Granulomas associated with active inflammation or infection will often exhibit increased FDG uptake on PET imaging, which can aid in differentiating them from benign lesions. It is important to note that increased FDG uptake is not specific for granulomas and can be seen in a variety of other conditions.

Laboratory Investigations: Unveiling Systemic Clues

Laboratory tests play a vital role in identifying systemic conditions associated with splenic granulomas. These investigations can provide valuable clues about the underlying etiology and guide further diagnostic workup.

Complete Blood Count (CBC)

A complete blood count is essential for evaluating blood cell populations. Cytopenias (e.g., anemia, thrombocytopenia, leukopenia) may suggest bone marrow involvement or hypersplenism, potentially narrowing the differential diagnosis.

Liver Function Tests (LFTs)

Liver function tests help assess for liver involvement, which is common in systemic diseases that can cause splenic granulomas. Elevated liver enzymes (e.g., AST, ALT) may indicate hepatitis or biliary obstruction.

Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP)

ESR and CRP are non-specific markers of inflammation. Elevated levels can suggest an underlying inflammatory or infectious process, prompting further investigation for specific etiologies.

Specific Infectious Disease Serology

Serological tests are crucial for identifying antibodies against specific pathogens known to cause granulomas. This may include testing for tuberculosis, histoplasmosis, brucellosis, and other relevant infections based on the patient's clinical history and geographical location.

Angiotensin-Converting Enzyme (ACE) Level

Elevated ACE levels are seen in some cases of sarcoidosis. This test can be a helpful adjunct in the diagnostic workup, although it is not specific for sarcoidosis.

Immunoglobulin Levels

Measuring immunoglobulin levels can help assess for lymphoproliferative disorders. Abnormal immunoglobulin levels may indicate underlying lymphoma or other immune-mediated conditions associated with splenic granulomas.

Splenic Biopsy: The Gold Standard for Definitive Diagnosis

While imaging and laboratory tests can provide valuable clues, splenic biopsy remains the gold standard for definitive diagnosis of splenic granulomas. This invasive procedure involves obtaining a tissue sample from the spleen for microscopic examination and further analysis.

Histopathology

Microscopic examination of tissue samples (histopathology) is essential for characterizing the granulomas and identifying potential etiologies. Pathologists evaluate the size, shape, and cellular composition of the granulomas, as well as the presence of necrosis or other distinctive features.

Special Stains

Special stains can be used to identify specific organisms within the granulomas. For example, acid-fast staining can detect mycobacteria (e.g., tuberculosis), while silver staining can identify fungi (e.g., histoplasmosis).

Culture

Culture is performed to isolate and identify infectious agents from the biopsy specimen. This is particularly important for diagnosing bacterial or fungal infections that may be difficult to detect with other methods.

Molecular Testing (PCR)

Molecular testing (PCR) can detect pathogen-specific DNA or RNA in the biopsy sample. This is particularly useful for identifying viruses or bacteria that are difficult to culture. PCR testing can also be used to detect genetic abnormalities associated with certain malignancies.

Treatment Approaches: Tailoring Therapy to the Underlying Cause

Splenic granulomas, while identifiable as distinct entities, often serve as clues pointing towards a broader, underlying systemic condition. Understanding the potential causes is paramount in guiding appropriate diagnostic and therapeutic strategies. This section will dissect the clinical management of splenic granulomas, emphasizing that treatment is almost always directed at the root cause rather than the granulomas themselves.

Antimicrobial Therapy for Infectious Etiologies

When splenic granulomas are a consequence of infection, antimicrobial therapy becomes the cornerstone of treatment. The specific agent and duration of therapy depend entirely on the identified pathogen.

For instance, tuberculosis, a common culprit, requires a multi-drug regimen typically involving isoniazid, rifampin, pyrazinamide, and ethambutol, administered over several months.

Histoplasmosis, a fungal infection, may necessitate treatment with antifungal medications like itraconazole or amphotericin B, particularly in disseminated cases or in immunocompromised individuals.

Accurate identification of the infectious agent through splenic biopsy and culture is crucial for guiding appropriate and effective antimicrobial therapy. Failure to adequately treat the underlying infection can lead to persistent granulomas and potentially life-threatening complications.

Corticosteroids for Inflammatory Conditions

In cases where splenic granulomas stem from inflammatory conditions like sarcoidosis, corticosteroids often play a significant role in management. Corticosteroids act as immunosuppressants, reducing the inflammatory response that drives granuloma formation.

Prednisone is commonly used, with the dosage and duration of treatment tailored to the severity of the disease and the patient's response. However, it's crucial to recognize that corticosteroids primarily address the inflammatory cascade and may not eliminate the underlying cause.

Long-term corticosteroid use can also lead to significant side effects, including weight gain, osteoporosis, and increased susceptibility to infections. Therefore, careful monitoring and consideration of alternative immunosuppressive agents, such as methotrexate or azathioprine, may be necessary in some patients.

Chemotherapy for Malignant Causes

When splenic granulomas are associated with malignancy, such as lymphoma or leukemia, chemotherapy becomes a critical component of the treatment strategy.

The specific chemotherapeutic regimen is determined by the type and stage of the cancer. For example, patients with Hodgkin's lymphoma may receive ABVD chemotherapy (adriamycin, bleomycin, vinblastine, dacarbazine).

In cases of leukemia with splenic involvement, treatment may involve chemotherapy, targeted therapies, and potentially stem cell transplantation.

The goal of chemotherapy is to eradicate the malignant cells, thereby addressing the underlying cause of the granulomas. Response to chemotherapy is carefully monitored through imaging studies and bone marrow biopsies.

Splenectomy: When Surgical Removal is Necessary

Splenectomy, the surgical removal of the spleen, is generally reserved for specific circumstances where other treatment modalities have failed, or when the spleen itself poses a significant threat.

Indications for splenectomy may include:

• Symptomatic Splenomegaly: When an enlarged spleen causes significant discomfort or complications.

• Hypersplenism: When the spleen is overactive, leading to the destruction of blood cells.

• Splenic Rupture: In rare cases, granulomas can weaken the spleen, predisposing it to rupture.

• Diagnostic Uncertainty: If a definitive diagnosis cannot be obtained through other means, splenectomy may be performed for diagnostic purposes.

Splenectomy carries inherent risks, including an increased susceptibility to certain infections. Post-splenectomy vaccination against encapsulated organisms like Streptococcus pneumoniae, Haemophilus influenzae type B, and Neisseria meningitidis is crucial.

Targeted Therapies for Specific Etiologies

The advent of targeted therapies has revolutionized the treatment landscape for many diseases, including some that can cause splenic granulomas.

Targeted therapies work by specifically targeting molecules involved in the pathogenesis of the underlying disease. For example, in certain lymphomas, monoclonal antibodies that target specific proteins on lymphoma cells may be used.

In some inflammatory conditions, biologic agents that block specific cytokines or immune pathways may be beneficial. The use of targeted therapies is highly individualized and depends on the specific etiology and characteristics of the disease.

Multidisciplinary Care: The Collaborative Approach to Splenic Granulomas

Splenic granulomas, while identifiable as distinct entities, often serve as clues pointing towards a broader, underlying systemic condition. Understanding the potential causes is paramount in guiding appropriate diagnostic and therapeutic strategies. Effective management necessitates a coordinated effort from various medical specialties, each contributing their unique expertise to ensure accurate diagnosis and optimal patient outcomes. This multidisciplinary approach acknowledges the complexity inherent in these cases and leverages the collective knowledge of a diverse team.

The Core Team: Key Specialists and Their Roles

The diagnostic journey and subsequent management of splenic granulomas often involve a team of specialists working in concert. Here's a breakdown of the core members and their respective roles:

Hematologists play a critical role, particularly when blood disorders like lymphoma or leukemia are suspected as the underlying cause.

Hematologists specialize in diagnosing and treating diseases of the blood and bone marrow.

They evaluate blood cell counts, perform bone marrow biopsies, and manage hematologic malignancies. Their expertise is vital in distinguishing between reactive granulomas and those associated with blood cancers.

Oncologists are brought in if the suspicion of malignancy is high, or if the diagnosis confirms a cancerous etiology.

Oncologists specialize in the treatment of cancer, including lymphoma and leukemia, both of which can manifest with splenic granulomas.

They develop and implement treatment plans involving chemotherapy, radiation therapy, targeted therapies, and immunotherapy. Their involvement is crucial in ensuring the patient receives appropriate cancer-specific care.

Infectious Disease Specialists are consulted when infectious etiologies, such as tuberculosis, histoplasmosis, or other systemic infections, are considered as potential drivers of granuloma formation.

These specialists possess expertise in diagnosing and treating complex infections.

They guide the selection of appropriate antimicrobial therapies, manage treatment duration, and address potential complications arising from infectious causes. Their involvement is critical in eradicating the underlying infection and preventing further granuloma formation.

Pathologists are essential for providing a definitive diagnosis based on tissue samples obtained through splenic biopsy.

Pathologists are medical doctors who specialize in examining tissues and cells under a microscope.

They analyze the histological features of the granulomas, identify infectious organisms using special stains, and perform molecular testing to detect specific pathogens. Their expertise is crucial for differentiating between various causes of granulomas and guiding treatment decisions.

The Extended Team: Additional Expertise

While the core team forms the foundation of care, other specialists may be consulted depending on the specific clinical scenario.

Radiologists play a vital role in interpreting imaging studies, such as CT scans and MRIs, to assess the size, location, and characteristics of splenic lesions.

Gastroenterologists may be consulted if there is suspected involvement of the gastrointestinal tract, such as in cases of Crohn's disease.

Rheumatologists may be involved in cases where inflammatory or autoimmune conditions are suspected, such as sarcoidosis or granulomatosis with polyangiitis.

Collaboration and Communication: The Key to Success

The effectiveness of a multidisciplinary approach hinges on seamless communication and collaboration among all members of the team.

Regular case conferences, shared electronic health records, and clear lines of communication are essential for ensuring that all relevant information is considered in the decision-making process.

This collaborative environment allows for a comprehensive assessment of the patient's condition and facilitates the development of an individualized treatment plan that addresses all aspects of their health. Ultimately, this coordinated effort leads to improved patient outcomes and a more holistic approach to care.

Key Takeaways: Consolidating Essential Concepts

Splenic granulomas, while identifiable as distinct entities, often serve as clues pointing towards a broader, underlying systemic condition. Understanding the potential causes is paramount in guiding appropriate diagnostic and therapeutic strategies. Effective management necessitates a firm grasp of the key concepts that define their etiology, presentation, and significance.

The Immunological Basis of Granuloma Formation

Granulomas are, at their core, a manifestation of the immune system's attempt to wall off substances it perceives as foreign or harmful. This process involves a complex interplay of immune cells, including macrophages, lymphocytes, and dendritic cells.

The formation of granulomas represents a chronic inflammatory response, often triggered by persistent antigens that the body cannot eliminate. Understanding this immunological basis is crucial for interpreting the presence of splenic granulomas.

Differential Diagnosis: Distinguishing Splenic Granulomas from Other Conditions

The presence of lesions in the spleen necessitates a careful process of differential diagnosis. Splenic granulomas can mimic other conditions, such as abscesses, cysts, or even metastatic tumors.

Distinguishing between these possibilities often requires a combination of imaging studies, laboratory investigations, and, ultimately, tissue biopsy. A thorough evaluation is essential to avoid misdiagnosis and ensure appropriate management.

Systemic Disease: Recognizing Splenic Granulomas as a Manifestation

One of the most critical considerations when encountering splenic granulomas is their potential to indicate an underlying systemic disease. Conditions such as tuberculosis, sarcoidosis, and certain malignancies can all manifest with granulomas in the spleen.

It is essential to view splenic granulomas not as an isolated finding, but as a potential clue to a more widespread condition. Failure to recognize this can lead to delays in diagnosis and treatment of the underlying disease.

The Role of Immunocompromised States

Immunocompromised individuals are particularly susceptible to developing splenic granulomas, especially from opportunistic infections. Conditions like HIV/AIDS, organ transplantation, and immunosuppressive therapies can impair the immune system's ability to control infections, leading to granuloma formation.

In these patients, a heightened index of suspicion for atypical infections and malignancies is warranted. Prompt investigation and treatment are crucial to prevent serious complications.

Caseous Necrosis: A Hallmark of Tuberculosis

Caseous necrosis, characterized by a cheese-like appearance, is a specific type of cell death commonly associated with tuberculosis. When granulomas in the spleen exhibit caseous necrosis, it strongly suggests a tuberculous etiology.

However, it is important to note that caseous necrosis is not exclusive to tuberculosis and can be seen in other infectious conditions. Confirmation requires further diagnostic testing.

Non-Caseating Granulomas: Sarcoidosis and Beyond

Non-caseating granulomas, which lack the central necrosis seen in caseous granulomas, are a hallmark of sarcoidosis. However, they can also be found in other conditions, such as Crohn's disease and certain drug reactions.

The presence of non-caseating granulomas in the spleen should prompt consideration of sarcoidosis, but it is essential to rule out other potential causes through appropriate investigations.

Video: Splenic Granulomas: Causes, Symptoms & Treatment

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So, that's the lowdown on splenic granulomas! While finding out you have them can be a bit unsettling, remember that most cases are benign and easily managed. If you're experiencing any of the symptoms we talked about, or if you're just concerned, definitely chat with your doctor. They'll be able to properly diagnose the cause of your splenic granulomas and help you figure out the best course of action.