
CT Scan Showed Possible Granuloma On Spleen And Have Petechiae On Breast. Worrisome

I am sorry to note that you are troubled with your symptoms and your doctors have not come to a diagnosis as yet.
The other tests that I would recommend with the itching and nights sweats (noted that the CBC was normal, and presume that the eosinophil count was also normal), are thyroid functions, mast cell tryptase, lymphocyte subsets for CD4/CD8 (not sensitive enough), bone marrow [invasive and painful test, not usually recommended as 1st line investigations] unless the mast cell tryptase was significantly elevated.
The petechiae if recent onset warrants a repeat of all previous tests. You must also let your doctor know of any recent travel abroad, or for viral serology/PCR as clinically indicated.
FSH, LH levels should be done and if elevated or borderline high will suggest a peri-menopausal state.
Granulomas in spleen are very difficult to confidently diagnose with a CT scan and MRI. PET imaging are more sensitive in knowing what the lesions are.
Immunoglobulin levels IgG, IgA, IgM, with serum electrophoresis must be done to ensure they are normal. Antibody deficiency syndromes and granulomas in spleen will suggest ‘Common Variable Immune Deficiency’ (CVID) like disorder that is quite common in the Western world. An Immunologist should then be involved in further work up and diagnoses/therapy.
I hope that helps.
Please get in touch if you have any queries.
Thanks.


Thanks for the follow up.
At present, I don’t think roller coaster rides would be related to the petechiae.
I think a conservative approach of 'watch and wait' is best for now. As your doctor has offered you the CT in 3-6 months, see what new information it provides.
As long as the current information shows that the spleen is not enlarged, antibody (IgG/A/M) levels are normal, with no problems with recurrent infections, as an Immunologist, I will not be too worried for now.
Hope I answered all your questions. Please use any answer clarification before closing and rating this answer. I will be happy to explain or expand on any issue you may have.
Best Wishes.

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