1/448. Unusual vascular changes in the red pulp of the spleen accompanying breast carcinoma metastasis.The prevalence of splenic metastasis from carcinomas varies between 2% and 13% in autopsy studies. Most of them are clinically inapparent. We report herein the case of a splenic metastasis revealing breast carcinoma in a 73-year old woman. splenectomy was performed to correct hypersplenism. Macroscopically, the cut surface of the spleen was uniform and pale. On microscopical examination, the metastatic infiltration involved both red and white pulp as single cells, cords and micro-nodules. Tumor cells were positive for cytokeratin and epithelial membrane antigen (EMA). The breast origin of this splenic metastasis was supported by the increase of CA 15-3 level, and by the appearance of axillary lymphadenopathy. In addition, the red pulp sinuses were obliterated by multiple thrombi at different stages of development and the splenic cords were collagenized. These changes could result from an unusual stromal reaction.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
2/448. Advanced primary Hodgkin's disease of the spleen cured by surgical resection: report of a case.We describe herein the case of a 61-year-old man who underwent successful resection of advanced primary Hodgkin's disease of the spleen. On admission, computed tomography and ultrasonography showed a fist-sized, slightly enhanced mass, and angiography demonstrated a typical neoplastic tumor stain in the spleen. Exploratory laparotomy revealed a hard mass invading the splenic hilar lymph nodes, gastric upper body, transverse colon, pancreatic tail, and left lateral segment of the liver. The patient underwent splenectomy with combined resection of the surrounding organs invaded by the tumor, followed by postoperative chemotherapy. Histological examination showed many reed-sternberg cells, and the tumor was subsequently diagnosed as Hodgkin's disease of the spleen. The patient is currently well without any signs of recurrence 4 years after surgery.- - - - - - - - - - ranking = 1.4keywords = spleen (Clic here for more details about this article) |
3/448. Inflammatory pseudotumor of the spleen associated with a cavernous hemangioma diagnosed at intra-operative cytology: report of a case and review of literature.This report presents a case of a 40 year old Caucasian female with a 15 cm inflammatory pseudotumor (IPT) of the spleen with associated areas of splenic hemangioma of the cavernous type. Abdominal CT showed a largely fatty splenic mass with enhancing septations, and scattered calcifications, and a small density in the liver. Grossly, the splenic lesion showed a lobulated cut surface with areas of myxoid change, necrosis, hemorrhage and cystic softening. The diagnosis of IPT was suggested at intraoperative consultation using cytologic smears and was, subsequently confirmed on permanent sections. Histologically, the lesion consisted of a densely collagenized spindle cell stroma with patchy aggregates of lymphocytes and plasma cells, and scattered foci showing hemosiderin-laden macrophages extracellular calcium deposits and osseous metaplasia. The stromal spindle cells were immuoreactive for smooth muscle actin and vimentin confirming their myofibroblastic phenotype. There were extensive areas of infarction within the mass. The patient, however, remained asymptomatic preoperatively. Histologic analysis in this case raises the possibility that low grade, perhaps repetitive, trauma to the hemangioma may have resulted in intralesional hemorrhages which, through a process of organization, may have evolved into this sizable inflammatory pseudotumor. In addition, this report reviews the current literature on the clinical significance and presentation, morphologic and immunohistochemical findings, prognosis, differential diagnosis, pathogenesis and therapy of the splenic IPT.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
4/448. Pathologic-spontaneous-rupture of the spleen as a presenting sign of splenic T-cell lymphoma--case report with review.A 39 year-old man presented for surgery with epigastric pain, tachycardia, hypotension and a progressive decrease of hemoglobin due to blood loss. Immediate abdominal ultrasonography followed by prompt paracentesis revealed massive intraperitoneal hemorrhage. During emergency laparotomy, a linear, actively bleeding rupture of an enlarged spleen was found and splenectomy was performed. The patient survived and the post-operative course was uneventful. Histopathology of the spleen as well as bone marrow biopsy confirmed the diagnosis of T-Cell lymphoma. Chemotherapy was initiated 3 weeks after surgery. To the best of our knowledge, this is the first reported case of previously undiagnosed T-Cell lymphoma presenting as pathologic rupture of the spleen.- - - - - - - - - - ranking = 1.4keywords = spleen (Clic here for more details about this article) |
5/448. Anaemia, thrombocytopenia and coagulopathy due to occult diffuse infantile haemangiomatosis of spleen and pancreas.Diffuse infantile haemangiomatosis of the spleen is a very rare lesion. Large haemangiomas may cause trapping of platelets and coagulation disorders known as Kasabach-Merrit syndrome. We here report the case of an infant with splenic and pancreatic haemangiomatosis presenting with life-threatening thrombocytopenia, anaemia and intravascular coagulation. diagnosis was hampered by reactive erythroblastosis and non-conclusive radiological findings. While treatment with corticosteroids was ineffective, administration of antithrombin iii improved coagulation parameters. After splenectomy the child recovered promptly and has remained free of disease for 3 years to date. CONCLUSION: Occult visceral haemangiomatosis without visible cutaneous haemangiomas should be included in the differential diagnosis of thrombocytopenia, anaemia and consumption coagulopathy. antithrombin iii treatment may be considered to overcome bleeding problems in patients with Kasabach-Merrit syndrome.- - - - - - - - - - ranking = 1keywords = spleen (Clic here for more details about this article) |
6/448. hemangiosarcoma of the spleen: report of a case and review of previously reported cases.Splenic hamangiosarcomas are rare tumors, usually discovered at autopsy. In a few instances the diagnosis was made premortem, at the time of splenectomy for spontaneous rupture. The tumors usually present with abdominal pain, left upper guadrant mass and tenderness, and occasionally with a microangiopathic type of anemia. The histogenesis of the tumor is in dispute. Some authors feel that they are degenerations of hemangiomas. Others feel that they arise de novo in the spleen. There is not proven association of thorotrast administration or vinyl chloride exposure to the development of hemangiosarcomas in the spleen. The prognosis of the tumor is uniformly poor and most of the patients surviving laparotomy have followed a uniformly fatal clinical course. In a few cases treated with chemotherapy there has been no evidence of clinical benefit. The case report in this article presented with essentially all the features enumerated above.- - - - - - - - - - ranking = 1.2keywords = spleen (Clic here for more details about this article) |
7/448. Atypical MRI presentation of a small splenic hamartoma.Hamartomas of the spleen usually appear isointense on T1-weighted MR images and hyperintense on T2-weighted images. We describe a histologically proven case which presented as a small (2.5 cm) focal mass isointense to splenic parenchyma on T1-weighted images and hypointense on both turbo-spin-echo T2 and short T1 inversion recovery images. Dynamic MRI revealed a delayed enhancement during the arterial phase becoming isointense and prolonged on subsequent images. This prolonged enhancement has previously been described as a characteristic pattern in these tumours. The lack of oedema and necrosis and the presence of fibrous tissue in the hamartoma at histopathology likely account for the low signal intensity on all sequences.- - - - - - - - - - ranking = 0.2keywords = spleen (Clic here for more details about this article) |
8/448. Primary splenic tuberculosis in a patient with nasal angiocentric lymphoma: mimicking metastatic tumor on abdominal CT.Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. The authors report a case of splenic tuberculosis mimicking metastatic tumor on computed tomography in a 60-year-old woman who had been treated with combination chemotherapy for nasal angiocentric lymphoma. Diagnostic splenectomy revealed multiple necrotic masses in the spleen, which were consistent with caseating granulomas microscopically. diagnosis was confirmed by positive cultures in Lowenstein medium, which grew typical mycobacterium tuberculosis organisms. Following splenectomy, the patient was also treated with a triple-drug antituberculosis regimen with no recurrence of her symptoms.- - - - - - - - - - ranking = 0.2keywords = spleen (Clic here for more details about this article) |
9/448. Splenic angiosarcoma--an unusual cause of bleeding gastrointestinal tract.Splenic angiosarcoma is a rare malignant vascular tumour with about 100 reported cases to date. The presentation of splenic angiosarcoma is highly variable, frequently causing diagnostic difficulty. It usually presents with splenomegaly, abdominal pain and occasionally with a microangiopathic type of anaemia. Here we report an additional case of primary angiosarcoma of the spleen presenting as a problem of bleeding from the gastrointestinal tract.- - - - - - - - - - ranking = 0.2keywords = spleen (Clic here for more details about this article) |
10/448. hemangioendothelioma of the spleen: imaging findings at color Doppler, US, and CT.The ultrasonographic, color Doppler, and computed tomography findings of an unusual vascular primary tumor of the spleen are reported. A brief clinical and histopathological analysis of this entity is discussed and the differential diagnosis of other primary lesions of the spleen is attempted.- - - - - - - - - - ranking = 1.2keywords = spleen (Clic here for more details about this article) |
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