Child with hard calcified abdomen

A young child with unsuspected tuberculosis (TB) presented with chronic pain abdomen along with off and on fever. He was admitted as case of lymphoma. X ray of the chest and abdomen showed diffuse miliary calcified lymph nodes and omental nodules. Aspiration yielded dry tap and hence Cartridge Based Nucleic Acid Amplification Test (CBNAAT) was not done. Omental biopsy revealed occasional mature lymphocytes, epithelioid histiocytes forming ill-defined granuloma. Ziehl Neelsen stain was non-contributory. The patient responded to anti tubercular drugs (prescribed for six months) and his abdomen softened. He was put on nutritional support which helped him regain health.