Hepatosplenic brucelloma: clinical presentation and imaging features in six cases.
BACKGROUND
We conducted a retrospective analysis of the clinical presentation and the computed tomographic (CT) and ultrasound (US) findings in six episodes of hepatosplenic brucelloma in five patients.


METHODS
In four episodes, the diagnosis was based on clinical history, serology, and characteristic imaging findings. In the other two episodes in the same patient, the diagnosis was suspected after a biopsy was taken. CT was performed in all six cases and US in five.


RESULTS
On US, brucellomas were iso- or hypoechogenic with the liver. Hyperechogenic masses were seen in one patient. Brucellomas were very poorly defined and contained small scattered cystic areas. All lesions showed central or marginal gross focal calcification, except multiple lesions in one patient. Contrast-enhanced CT showed predominantly solid masses with irregular borders and fine or thick enhancing trabeculations separating hypodense solid areas and/or small cystic areas. Two patients showed transdiaphragmatic lung invasion by brucelloma, a complication not previously published.


CONCLUSIONS
In regions where brucellosis is endemic, brucelloma should be included in the differential diagnosis if a hepatic or splenic mass with irregular borders and central or marginal gross focal calcification is detected, and contrast-enhanced CT shows enhancing trabeculations that separate hypodense solid areas and/or small liquid collections.
Ruiz Carazo
E
E
Diagnostic Imaging Department, Virgen de las Nieves University Hospital, Avenida Coronel Muñoz s/n, E-18012 Granada, Spain. eruiz@fundacionhvn.org
Muñoz Parra
F
F
Jiménez Villares
M P
MP
del Mar Castellano García
M
M
Moyano Calvente
S L
SL
Medina Benítez
A
A
D000328:Adult; D002006:Brucellosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography