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Inflammatory Pseudotumor of the Spleen.

Georgia M, Rady K, Prince HM - Hematol Rep (2015)

Bottom Line: Isolated splenic inflammatory pseudotumors (IPT) are extremely rare, typically benign, inflammatory lesions with varied clinical presentations that pose a diagnostic challenge to clinicians due to their similarity in appearance to neoplasms.We present the case of a young woman diagnosed with a splenic IPT following investigation for persistent anemia, raised inflammatory markers, and polyclonal hypergammaglobulinemia, whose symptoms resolved completely following splenectomy.This case highlights the need to consider this diagnosis when evaluating patients with a splenic mass of unknown etiology.

View Article: PubMed Central - PubMed

Affiliation: Peninsula Health, Frankston Hospital, Victoria Melbourne, Victoria, Australia.

ABSTRACT
Isolated splenic inflammatory pseudotumors (IPT) are extremely rare, typically benign, inflammatory lesions with varied clinical presentations that pose a diagnostic challenge to clinicians due to their similarity in appearance to neoplasms. We present the case of a young woman diagnosed with a splenic IPT following investigation for persistent anemia, raised inflammatory markers, and polyclonal hypergammaglobulinemia, whose symptoms resolved completely following splenectomy. This case highlights the need to consider this diagnosis when evaluating patients with a splenic mass of unknown etiology.

No MeSH data available.


Related in: MedlinePlus

A) Hematoxylin and Eosin stain of splenic tissue demonstrating a lesion with haphazardly arranged fibroblasts with extensive hemorrhage, clusters of mature plasma cells, eosinophils and small numbers of lymphocytes. B) Smooth muscle actin stain demonstrating heavy fibroblastic component.
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fig003: A) Hematoxylin and Eosin stain of splenic tissue demonstrating a lesion with haphazardly arranged fibroblasts with extensive hemorrhage, clusters of mature plasma cells, eosinophils and small numbers of lymphocytes. B) Smooth muscle actin stain demonstrating heavy fibroblastic component.

Mentions: In view of the PET-avid splenic lesion, an uncomplicated, elective, laparoscopic splenectomy was performed for diagnostic and treatment purposes. On inspection, the spleen was partially morcelated, weighting 178 grams with no discrete lesion identified on serial sectioning. Microscopically, some sections showed replacement of splenic parenchyma by a lesion with abundant calcification and iron deposition, which was composed of interlacing fascicles of haphazardly arranged spindled myofibroblasts with extensive hemorrhage, and a polymorphic inflammatory infiltrate comprising plasma cells, eosinophils, small mature lymphocytes, and hemosiderin-laden macrophages (Figure 3A). The adjacent spleen appeared normal with preserved red and white pulp. The myofibroblastic cells were strongly positive for SMA (Figure 3B) and negative for desmin, CD34, CD21, CD8, and ALK1. Additional stains show that the majority of spindled cells are negative for S100 protein, and no acid fast bacilli were seen with Ziehl-Neelsen and Wade Fite stains. In-situ hybridization for Epstein-Barr virus encoded-small RNA’s (EBER) and HHV8 were negative. A diagnosis of splenic IPT was made.


Inflammatory Pseudotumor of the Spleen.

Georgia M, Rady K, Prince HM - Hematol Rep (2015)

A) Hematoxylin and Eosin stain of splenic tissue demonstrating a lesion with haphazardly arranged fibroblasts with extensive hemorrhage, clusters of mature plasma cells, eosinophils and small numbers of lymphocytes. B) Smooth muscle actin stain demonstrating heavy fibroblastic component.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508554&req=5

fig003: A) Hematoxylin and Eosin stain of splenic tissue demonstrating a lesion with haphazardly arranged fibroblasts with extensive hemorrhage, clusters of mature plasma cells, eosinophils and small numbers of lymphocytes. B) Smooth muscle actin stain demonstrating heavy fibroblastic component.
Mentions: In view of the PET-avid splenic lesion, an uncomplicated, elective, laparoscopic splenectomy was performed for diagnostic and treatment purposes. On inspection, the spleen was partially morcelated, weighting 178 grams with no discrete lesion identified on serial sectioning. Microscopically, some sections showed replacement of splenic parenchyma by a lesion with abundant calcification and iron deposition, which was composed of interlacing fascicles of haphazardly arranged spindled myofibroblasts with extensive hemorrhage, and a polymorphic inflammatory infiltrate comprising plasma cells, eosinophils, small mature lymphocytes, and hemosiderin-laden macrophages (Figure 3A). The adjacent spleen appeared normal with preserved red and white pulp. The myofibroblastic cells were strongly positive for SMA (Figure 3B) and negative for desmin, CD34, CD21, CD8, and ALK1. Additional stains show that the majority of spindled cells are negative for S100 protein, and no acid fast bacilli were seen with Ziehl-Neelsen and Wade Fite stains. In-situ hybridization for Epstein-Barr virus encoded-small RNA’s (EBER) and HHV8 were negative. A diagnosis of splenic IPT was made.

Bottom Line: Isolated splenic inflammatory pseudotumors (IPT) are extremely rare, typically benign, inflammatory lesions with varied clinical presentations that pose a diagnostic challenge to clinicians due to their similarity in appearance to neoplasms.We present the case of a young woman diagnosed with a splenic IPT following investigation for persistent anemia, raised inflammatory markers, and polyclonal hypergammaglobulinemia, whose symptoms resolved completely following splenectomy.This case highlights the need to consider this diagnosis when evaluating patients with a splenic mass of unknown etiology.

View Article: PubMed Central - PubMed

Affiliation: Peninsula Health, Frankston Hospital, Victoria Melbourne, Victoria, Australia.

ABSTRACT
Isolated splenic inflammatory pseudotumors (IPT) are extremely rare, typically benign, inflammatory lesions with varied clinical presentations that pose a diagnostic challenge to clinicians due to their similarity in appearance to neoplasms. We present the case of a young woman diagnosed with a splenic IPT following investigation for persistent anemia, raised inflammatory markers, and polyclonal hypergammaglobulinemia, whose symptoms resolved completely following splenectomy. This case highlights the need to consider this diagnosis when evaluating patients with a splenic mass of unknown etiology.

No MeSH data available.


Related in: MedlinePlus