Clinical Presentation

A 35-year-old woman presents with vague abdominal pain.

Infused computed tomography shows hypodense micronodules scattered evenly throughout an enlarged spleen (arrows).

Differential Diagnosis

• Lymphoma: This is the most common neoplasm causing the pattern of micronodularity and is the most likely diagnosis for fine, evenly distributed, innumerable nodules, as in this case.

• Leukemia: As a second consideration, leukemia can have an identical appearance.

• Fungal infections: These can cause hepatosplenic microabscesses, most commonly candidiasis and histoplasmosis .

• Tuberculosis: In its disseminated form, tuberculosis can cause hepatosplenic microabscesses.