A Study Describes a "Pomegranate" Spleen as a Result of Disseminated Tuberculosis

A study led by Dr Quique Bassat and Dr Alberto García-Basteiro in a joint effort involving researchers from ISGlobal, the Central Hospital of Maputo and the Manhica Health Research Centre (CISM), has been published in the American Journal of Respiratory and Critical Care Medicine (AJRCCM), one of the top journals in the field of respiratory diseases.

The authors describe the case of a woman whose cause of death, determined post-mortem, was disseminated tuberculosis (TB) and whose spleen showed multiple yellowish nodules with a characteristic aspect of pomegranate. The presence of Mycobacterium tuberculosis (the TB-causing agent) in the lesions was confirmed by molecular techniques.

"This typical aspect" explains Dr García-Basteiro "is not uncommon in countries where TB is not a public health problem but may be more frequent than previously thought in countries where HIV is the main risk factor for TB, for example in Mozambique and other sub-Saharan countries."

The authors conclude that this type of spleen lesions could guide pathologists in establishing disseminated TB diagnosis, especially in high-burden TB/HIV countries. 

"This finding, observed in several patients of the study, could go unnoticed due to the limited practice of autopsies in low-resource countries," claims Dr Bassat. The study is part of CaDMIA, a large project that seeks to validate the use of minimally invasive autopsies to determine the causes of death in sub-Saharan Africa and Brazil.

Reference: Alberto L. García-Basteiro, Mamudo R. Ismail, Carla Carrilho, Esperança Ussene, Paola Castillo,Dércio Jordão, Lucília Lovane, Cesaltina Lorenzoni, Miguel J. Martínez, Jaume Ordi, Clara Menéndez, and Quique Bassat ""Pomegranate" Spleen in Disseminated Tuberculosis", American Journal of Respiratory and Critical Care Medicine, Vol. 192, No. 3 (2015), pp. 387-388.