Sclerosing angiomatoid nodular transformation (SANT) of the spleen can be safely diagnosed by a core percutaneous ultrasound-guided biopsy

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign lesion of the spleen. SANT cannot be distinguished from other benign or malignant splenic tumors based on imaging findings. So, diagnosis relies on histopathologic examination. Although splenectomy is frequently considered as an option, core needle biopsy tissue analysis is safe and accurate to avoid surgery.

Hepatosplenic schistosomiasis: a rare cause of chronic liver disease with portal hypertension diagnosed by abdominal ultrasound

Hepatosplenic schistosomiasis (HSS) is a major cause of chronic liver disease with portal hypertension (pHTN) in Africa, Asia and America. Abdominal ultrasound is essential in its diagnosis.

Percutaneous and endoscopic ultrasound-guided splenic biopsies are both safe procedures with a high diagnostic accuracy

Splenic biopsy is a necessary diagnostic procedure. It has been proved that it is a safe procedure with a high diagnostic accuracy. However, the decision of percutaneous or endoscopic ultrasound-guided approach should be assessed taking into consideration patients' characteristics and the experience of each center.

Correction: Randomized prospective study evaluating tenofovir disoproxil fumarate prophylaxis against hepatitis B virus reactivation in anti-HBc-positive patients with rituximab-based regimens to treat hematologic malignancies: The Preblin study

[This corrects the article DOI: 10.1371/journal.pone.0184550.].

Randomized prospective study evaluating tenofovir disoproxil fumarate prophylaxis against hepatitis B virus reactivation in anti-HBc-positive patients with rituximab-based regimens to treat hematologic malignancies: The Preblin study

BACKGROUND

Hepatitis B virus (HBV) reactivation in patients with resolved HBV infection (HBsAg negative, antiHBc positive) is uncommon, but potentially fatal. The role of HBV prophylaxis in this setting is uncertain. The aim of this study was to compare the efficacy of tenofovir disoproxil fumarate (TDF) prophylaxis versus close monitoring in antiHBc-positive, HBsAg-negative patients under treatment with rituximab (RTX)-based regimens for hematologic malignancy.

METHODS

PREBLIN is a phase IV, randomized, prospective, open-label, multicenter, parallel-group trial conducted in 17 hospitals throughout Spain. Anti-HBc-positive, HBsAg-negative patients with undetectable HBV DNA were randomized to receive TDF 300 mg once daily (Group I) or observation (Group II). The primary endpoint was the percentage of patients showing HBV reactivation during 18 months following initiation of RTX treatment. Patients with detectable HBV DNA (Group III) received the same dose of TDF and were analyzed together with Group I to investigate TDF safety.

RESULTS

Sixty-one patients were enrolled in the study, 33 in the TDF treatment group and 28 in the observation group. By ITT analysis, HBV reactivation was 0% (0/33) in the study group and 10.7% (3/28) in the observation group (p = 0.091). None of the patients in either group showed significant differences in liver function parameters between baseline and the last follow-up sample. TDF was generally well tolerated and there were no severe treatment-related adverse events.

CONCLUSION

In patients with hematological malignancy and resolved hepatitis B infection receiving RTX-based regimens, HBV reactivation did not occur in patients given TDF prophylaxis.

[Symptomatic hypercalcemia presenting as a case of isolated splenic tuberculosis]

BACKGROUND AND OBJECTIVE

To describe an unusual clinical presentation as isolated splenic tuberculosis.

PATIENT AND METHODS

We report a case of isolated splenic tuberculosis, a rare form of extrapulmonary tuberculosis in an immunocompetent patient, and, as a peculiarity, debuts in the form of symptomatic hypercalcemia.

RESULTS

We deeply report the clinical case and the procedures performed to exclude other diseases. We emphasize the usefulness of fine needle aspiration of the spleen to obtain microbiological samples, and the use of specific polymerase chain reaction for mycobacterias to establish the definitive diagnosis of this entity. In agreement with other authors, we chose initial medical treatment with antituberculous drugs, reserving surgery for refractory cases or in case of spontaneous splenic rupture.

CONCLUSION

Hypercalcemia can be a presentation of granulomatous diseases. The isolated involvement of the spleen by mycobacterias is a rare form of extrapulmonary tuberculosis and more so in immunocompetent patients.