Hepatosplenomegaly is a very significant finding in an abdominal examination and often leads to a study of the entire gamut of differential diagnoses. The more common causes of this interesting change are sufficiently well catalogued to show tuberculosis as an infrequent offender. However, because of its obscurity and its amenability to treatment, tuberculosis of the spleen forms a worthy chapter in the study of the surgical splenopathies.
Intelligent understanding of this disease dates back to Winternitz'1 work. According to Winternitz, and this has been substantiated by most subsequent writers, tuberculosis of the spleen is not a primary disease in the strict pathologic sense. Evidence of earlier tuberculous infection was found in all his autopsies. However, as a clinical entity the disease may be considered primary. In the spleen, tuberculosis may form an active focus for systemic infection. In this respect splenic tuberculosis is analogous to renal tuberculosis, which is