We report a case of unusual presentation of a patient with hemangioma of the spleen. The patient had presented with recurrent gastric hemorrhage and significant weight loss, due to ruptured hemangioma of the spleen and associated splenic tuberculosis. The true nature of the lesions remained a diagnostic dilemma despite complete radiological workup and review of literature.

Objective: To study the spectrum of computed tomographic (CT) morphologies of intracranial tuberculomas and to show the role of CT in evaluating the response to medical management. Subjects and Methods: The case files and CT scans of 20 patients with proven intracranial tuberculomas over a period of 15 years (1985–1999) were reviewed retrospectively. All the patients had pre- and post-contrast axial CT scans of the brain. Follow-up CT studies were done 2–12 months after starting antituberculous chemotherapy (ATT). Results: There were 15 males and 5 females. Single lesions were seen in 65% of patients. The majority of the lesions (78%) were in the frontal and parietal lobes. Rare sites of presentation included midbrain and basal ganglia. The lesions were isodense in 81% of the precontrast studies and all were enhanced after intravenous administration of the contrast medium. Severe mass effect, hydrocephalus and meningeal enhancement were not common findings. In 80% of the patients the follow-up CT scans showed evidence of response to ATT. Conclusion: CT is a reliable modality in the diagnostic workup and follow-up of patients with intracranial tuberculomas. Administration of contrast medium is mandatory for the evaluation of such patients.