FOCAL SPLENIC LESIONS IN PATIENTS WITH AIDS - SONOGRAPHIC FINDINGS

Background: The purpose of this study was to describe the sonographic features of the focal splenic lesions in patients with AIDS and to kno w the frequency and etiology of these features. Methods: Sonographic e xams of 278 AIDS patients were reviewed retrospectively. We recorded t he clinical indications for sonograms and sonographic findings of thos e patients with focal splenic lesions. In addition, patients' historie s were reviewed to determine the etiology of such lesions. Ultrasound exams were performed with a 3.5-MHz transducer. Results: Sonography de mostrated focal splenic lesions in 22 patients (7.9%). Eighteen patien ts (81.8%) showed small, multiple, hypoechoic, rounded splenic lesions ; one patient had a solitary defect with similar features. In these 19 patients (86.3%), splenic lesions were due to disseminated Mycobacter ium tuberculosis infection. One case showed two large hypoechoic wedge -shaped lesions that were splenic infarctations secondary to acute bac terial endocarditis, In two patients (9%) with solitary and multiple s mall hypoechoic lesions, the cause of the lesions remained unknown. Al l patients had splenomegaly. Hepatomegaly with focal lesions, retroper itoneal lymphadenopathy, or ascites were also seen. Conclusion: In our area, the finding of splenomegaly with small, multiple, hypoechoic le sions in AIDS patients should make clinicians suspect splenic tubercul osis as a first possibility.