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Yamane H, Fukuda N, Nishino K, Yoshida K, Ochi N, Yamagishi T, Honda Y, Kawamoto H, Monobe Y, Mimura H, Naomoto Y, Takigawa N. Non-occlusive mesenteric ischemia after splenic metastasectomy for small-cell lung cancer. Intern Med 2015; 54:743-7. [PMID: 25832935 DOI: 10.2169/internalmedicine.54.3545] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 68-year-old man presented with severe abdominal pain. Seven months earlier, he had received systemic chemotherapy for small-cell lung cancer with solitary metastasis to the spleen, followed by splenectomy. Abdominal computed tomography and abdominal arterial angiography showed diffuse ischemia of the mesenteric artery without apparent occlusion. The patient also suffered from septicemia caused by Enterococcus faecium. Therefore, a diagnosis of non-occlusive mesenteric ischemia (NOMI) induced by septicemia was supposed. Although treatment with antibiotics and papaverine hydrochloride was administered and the necrotic tissue in the intestinal tract was resected, the patient died. Physicians should be aware that patients undergoing splenectomy are likely to be affected by septicemia, which may subsequently induce NOMI.
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27
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Matsuda I, Okada M, Inoue T, Tokugawa T, Ogawa H, Hirota S. Primary follicular lymphoma of the spleen incidentally found in a patient with alcohol- and hepatitis C-related liver cirrhosis. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:4484-4488. [PMID: 25120838 PMCID: PMC4129073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/02/2014] [Indexed: 06/03/2023]
Abstract
Primary splenic lymphoma is rare as non-Hodgkin lymphomas. Splenic infiltration of lymphoma cells may cause splenomegaly in many cases. However, splenomegaly is caused not only by tumor involvement but also by non-tumorous disorders. One of the most prevalent non-neoplastic causes is portal hypertension mostly due to liver cirrhosis. On the other hand, liver cirrhosis may underlie various extrahepatic manifestations including development of B-cell non-Hodgkin lymphomas. Here, we report a case of primary follicular lymphoma of the spleen in a patient with liver cirrhosis related to hepatitis C and alcohol. The lymphoma was incidentally found in an enlarged spleen resected palliatively to alleviate symptomatic pancytopenia of the patient. The main characteristic of our case is an incidental finding of a rare situation brought by careful pathological examination. Our case illustrates the importance to recognize a possibility of co-occurrence of chronic liver disease and extrahepatic lymphoma.
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Rosenblatt P, Koka R, Chen Q, Papadimitriou JC, Sausville EA, Emadi A. Schistocytes, echinocytes, iron deficiency anemia, and thrombocytopenia - hematologic manifestations of splenic angiosarcoma. ARCHIVES OF IRANIAN MEDICINE 2014; 16:602-5. [PMID: 24093143 DOI: 0131610/aim.0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Splenic angiosarcoma is a rare and aggressive malignancy with an incidence of less than one per million and a fatality rate over 90%. Early diagnosis is of great importance for optimal management. Here, we report the case of a patient with splenic angiosarcoma who presented with prominent schistocytes, echinocytes, thrombocytopenia, and iron deficiency anemia, which in combination with radiographic evidence of a splenic mass, raised the suspicion for angiosarcoma and resulted in a prompt surgical intervention with curative intent. Resolution of the hematologic findings following splenectomy suggests that patients with this malignancy should be monitored for recurrent hematologic abnormalities as they may herald recurrence of the disease. We present a literature review on the hematologic manifestations that is associated with this malignant disease.
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29
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Ge R, Liu C, Yin X, Chen J, Zhou X, Huang C, Yu W, Shen X. Clinicopathologic characteristics of inflammatory pseudotumor-like follicular dendritic cell sarcoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:2421-2429. [PMID: 24966952 PMCID: PMC4069939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 04/25/2014] [Indexed: 06/03/2023]
Abstract
Inflammatory pseudotumor (IPT)-like follicular dendritic cell (FDC) sarcoma is a recently described rare tumor and considered a unique entity, with different histologic appearances and behavior from those of the classical FDC sarcoma. This study analyzed the clinical and pathological findings of two such cases that the authors encountered and 36 previously reported cases identified in the literature. Assessment of all 38 cases showed a slight female predominance (2.2:1) with a median age of 56.5 years. Seventeen patients complained of abdominal discomfort or pain, while fifteen patients had no clinical symptom. Almost all cases occurred in liver (n=20) or spleen (n=17). Except in one case, all patients underwent surgical resection of the tumor alone. Histologic features showed a mixture of chronic inflammatory cells and variable amounts of spindle cells with vesicular nuclei and distinct nucleoli. The tumor cells expressed conventional FDC markers such as CD21 (75%), CD35 (92%), CD23 (62%), clusterin (75%), and CNA.42 (100%). EBV was detected in thirty-five cases (92.1%) by Epstein-Barr virus (EBV)-encoded RNA in situ hybridization, and EBV-latent membrane protein-1 was expressed in 90% of the cases. With a median follow-up of 21 months, 29 patients (85.3%) were alive and well, 4 (11.8%) were alive with disease, one patient (2.9%) died of disease. Only four patients with hepatic tumors underwent recurrence or metastasis after initial treatment. Epstein-Barr virus is thought to play a role in the development of the tumor; however, the pathogenesis of the disease and the origin of tumor cells remain unclear.
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MESH Headings
- Abdominal Pain/etiology
- Aged
- Biomarkers, Tumor/analysis
- Biopsy
- DNA, Viral/genetics
- Dendritic Cell Sarcoma, Follicular/complications
- Dendritic Cell Sarcoma, Follicular/metabolism
- Dendritic Cell Sarcoma, Follicular/mortality
- Dendritic Cell Sarcoma, Follicular/pathology
- Dendritic Cell Sarcoma, Follicular/surgery
- Dendritic Cell Sarcoma, Follicular/virology
- Dendritic Cells, Follicular/chemistry
- Dendritic Cells, Follicular/pathology
- Dendritic Cells, Follicular/virology
- Female
- Granuloma, Plasma Cell/complications
- Granuloma, Plasma Cell/metabolism
- Granuloma, Plasma Cell/mortality
- Granuloma, Plasma Cell/pathology
- Granuloma, Plasma Cell/surgery
- Granuloma, Plasma Cell/virology
- Hepatectomy
- Herpesvirus 4, Human/genetics
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Liver Neoplasms/chemistry
- Liver Neoplasms/complications
- Liver Neoplasms/mortality
- Liver Neoplasms/pathology
- Liver Neoplasms/surgery
- Liver Neoplasms/virology
- Male
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Recurrence, Local
- Predictive Value of Tests
- Risk Factors
- Splenectomy
- Splenic Neoplasms/chemistry
- Splenic Neoplasms/complications
- Splenic Neoplasms/mortality
- Splenic Neoplasms/pathology
- Splenic Neoplasms/surgery
- Splenic Neoplasms/virology
- Time Factors
- Treatment Outcome
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30
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Aqil B, Green LK, Lai S. Primary splenic angiosarcoma associated with anemia, leukocytosis and thrombocytopenia. ANNALS OF CLINICAL AND LABORATORY SCIENCE 2014; 44:217-221. [PMID: 24795063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Primary angiosarcoma of the spleen is a rare neoplasm arising from endothelial cells. It is an aggressive neoplasm with a poor prognosis. We report a case of 61-year-old Caucasian man who presented with shortness of breath, anemia, leukocytosis, and thrombocytopenia. Ultrasound Sonogram (US) and Computed Tomography (CT) scans revealed a massively enlarged spleen with numerous enhancing hypodense lesions. The spleen was adherent to the omentum, retroperitoneum, and tail of the pancreas. Image-guided Fine Needle Aspiration (FNA) revealed an atypical spindle cell lesion. Resection of the spleen and attached tail of pancreas was performed. Histological examination and immunohistochemical studies revealed a diffuse vascular malignant neoplasm with features of angiosarcoma. The patient appeared disease free after resection. He died within 5 months of unknown etiology.
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Mokhtari N, Hamidian Jahromi A, Dela Cruz N, Woodward A, Do D, Thomas-Ogunniyi JO, Sangster G. Littoral cell angioma: review of the literature and case report. THE JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY : OFFICIAL ORGAN OF THE LOUISIANA STATE MEDICAL SOCIETY 2013; 165:329-333. [PMID: 25073259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Littoral cell angioma (LCA), a primary vascular neoplasm originating from splenic red pulp littoral cells, was initially thought to be an extremely rare pathology. There have been an increasing number of cases reported in the literature. However, the etiology and prevalence of LCA is still unclear, partly due to the rarity of cases. The association of LCA with internal organ cancers, specifically lymphoma, has also been reported. In the patients with a history of cancer/lymphoma, the accurate diagnosis of LCA as the cause of the splenomegaly is challenging. Here we present a case of LCA in a patient with non-Hodgkin B-cell lymphoma and alpha-thalassemia trait. To our knowledge, this is the first report of the coexistence of LCA and thalassemia and only the second report of LCA and marginal-zone non-Hodgkin B-cell lymphoma. We review the literature and discuss the radiologic and pathologic findings of this case compared with the previously reported cases.
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Chen BC, Wang HH, Lin YC, Shih YL, Chang WK, Hsieh TY. Isolated gastric variceal bleeding caused by splenic lymphoma-associated splenic vein occlusion. World J Gastroenterol 2013; 19:6939-6942. [PMID: 24187474 PMCID: PMC3812498 DOI: 10.3748/wjg.v19.i40.6939] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 08/12/2013] [Accepted: 08/17/2013] [Indexed: 02/06/2023] Open
Abstract
Isolated gastric varices (IGV) can occur in patients with left-sided portal hypertension resulting from splenic vein occlusion caused by thrombosis or stenosis. In left-sided portal hypertension, blood flows retrogradely through the short and posterior gastric veins and the gastroepiploic veins, leading to the formation of an IGV. The most common causes of splenic vein occlusion are pancreatic diseases, such as pancreatic cancer, pancreatitis, or a pseudocyst. However, various other cancers, such as colon, gastric, or renal cancers, have also been known to cause splenic vein occlusion. Our patient presented with a rare case of IGV bleeding induced by splenic lymphoma-associated splenic vein occlusion. Splenectomy, splenic artery embolization, and stenting of the splenic vein are the current treatment choices. Chemotherapy, however, is an alternative effective treatment for splenic vein occlusion caused by chemotherapy-sensitive tumors. Our patient responded well to chemotherapy with a cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone regimen, and the splenic vein occlusion resolved after the lymphoma regressed.
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33
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Saeed A, Alkhazna A. An adult patient with respiratory failure and splenomegaly. J Clin Virol 2013; 59:77-80. [PMID: 23850172 DOI: 10.1016/j.jcv.2013.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 06/12/2013] [Accepted: 06/16/2013] [Indexed: 11/20/2022]
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34
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Yu SC, Lin CW. Early-stage splenic diffuse large B-cell lymphoma is highly associated with hepatitis C virus infection. Kaohsiung J Med Sci 2012; 29:150-6. [PMID: 23465418 DOI: 10.1016/j.kjms.2012.08.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 05/07/2012] [Indexed: 02/07/2023] Open
Abstract
Splenic marginal zone lymphoma (SMZL) and splenic diffuse large B-cell lymphoma (DLBCL) are the most common types of lymphomas involving the spleen. Geographic variation in hepatitis C virus (HCV) seroprevalence is characteristic of splenic lymphomas. In Italy, HCV seroprevalence was higher in patients with SMZL and splenic DLBCL than in patients with all types of lymphoma. In Japan, HCV seroprevalence was higher in patients with splenic DLBCL than in patients with all types of lymphoma; however, HCV seroprevalence in patients with SMZL was similar to that in patients with all types of lymphoma. In this study, clinicopathological data of 74 splenic lymphoma cases between 1988 and 2011 collected from the Department of Pathology at National Taiwan University Hospital were analyzed. Serology for HCV infection was available for 41 cases. Splenic DLBCL and SMZL accounted for 36% (n = 27) and 42% (n = 31) of splenic lymphomas, respectively. Microscopically, most cases of DLBCL (26/27) presented with circumscribed tumor and most cases of SMZL (28/31) presented with white pulp expansion. HCV seroprevalence in patients with DLBCL and SMZL was 44% and 10%, respectively (7/16 vs. 2/20, p = 0.020). The pattern identified in this study is closer to that in Japan than in Italy. HCV seroprevalence in patients with early-stage (I/II) and late-stage (III/IV) DLBCL was 100% and 10%, respectively (6/6 vs. 1/10, p < 0.001). Early-stage DLBCL is clinically considered a form of primary splenic lymphoma rather than a systemic lymphoma with splenic involvement. High HCV seroprevalence in patients with early-stage DLBCL suggests a role of HCV in the pathogenesis of primary DLBCL.
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MESH Headings
- Female
- Hepatitis C/complications
- Hepatitis C/epidemiology
- Hepatitis C/pathology
- Humans
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/epidemiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Seroepidemiologic Studies
- Spleen/pathology
- Splenic Neoplasms/complications
- Splenic Neoplasms/epidemiology
- Splenic Neoplasms/pathology
- Taiwan/epidemiology
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Spasić M, Radovanović D, Canović D, Azanjac G, Djurdjević P, Mitrović S. Combined lymphangioma and hemangioma of the spleen in a patient with Klippel-Trénaunay syndrome. SRP ARK CELOK LEK 2012; 140:777-781. [PMID: 23350256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Klippel-Trenaunay syndrome (KTS) is a very rare congenital anomaly of blood vessels, characterized by the following clinical triad: varicose superficial veins, port-wine stain and usually bony and soft tissue hypertophy of extremities, most often located in the lower extremities. It is often accompanied by visceral manifestations, and rarely combined with splenomegaly. CASE OUTLINE A 30-year-old female patient came to the Surgery Clinic because of occasional left hypochondrial pain. After she was diagnosed with KTS combined with splenomegaly, splenectomy was performed. Macroscopic and microscopic spleen examination indicated the presence of tumor of vascular origin, presenting a combination of lymphangioma and hemangioma. CONCLUSION Diagnosed KTS demands a thorough clinical examination of the patient because of the potential presence of visceral manifestations. When splenomegaly is present, even though being often benign, splenectomy is usually performed to alleviate accompanying symptoms which occur as a result of organ enlargement and compression, to prevent rupture and consequential bleeding when the vascular spleen tumor is large, and finally to avoid a possibility of malignant transformation.
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36
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Sajid MS, Howell P, Leaver C, Roberts K, Sains P. Spontaneous splenic rupture secondary to metastatic malignant spindle cell tumour. Singapore Med J 2012; 53:e208-e210. [PMID: 23112031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report a case of pathological splenic rupture as a manifestation of malignant metastatic spindle cell tumour. To the best of our knowledge, this is the first case report of an atraumatic-pathological rupture of the spleen secondary to metastatic malignant spindle cell tumour. A 63-year-old man with a previous history of right upper limb amputation for an axillary malignant spindle cell tumour was admitted with an acute abdomen. Computed tomography showed a ruptured spleen. The patient subsequently underwent splenectomy. Histopathology confirmed the presence of malignant metastatic spindle cell tumour. Pathological splenic rupture is a rare manifestation of metastatic malignant spindle cell tumour. Background oncological history and thorough examination of the musculoskeletal system may provide important clues to make a prompt diagnosis.
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37
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Du J, McKay J, Mason D, Broadhurst G. Spontaneous splenic rupture secondary to metastatic adenocarcinoma of the prostate. ANZ J Surg 2012; 82:566-7. [PMID: 22863232 DOI: 10.1111/j.1445-2197.2012.06107.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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38
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Genet P, Chaoui D, Fourcade C, Masse V, Courdavault L, Sutton L, Al Jijakli A, Arakelian N, Wifaq B. Splenic marginal zone lymphoma with villous lymphocytes in patients with human immunodeficiency virus. Leuk Lymphoma 2012; 54:181-3. [PMID: 22646999 DOI: 10.3109/10428194.2012.698389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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39
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Vase MØ, Hellberg YK, Larsen CS, Petersen E, Schaumburg H, Bendix K, Ravel C, Bastien P, Christensen M, d'Amore F. Development of splenic marginal zone lymphoma in a HIV-negative patient with visceral leishmaniasis. Acta Haematol 2012; 128:20-2. [PMID: 22572474 DOI: 10.1159/000337341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 02/13/2012] [Indexed: 12/13/2022]
MESH Headings
- Amphotericin B/therapeutic use
- Antiprotozoal Agents/therapeutic use
- Bone Marrow/pathology
- HIV/genetics
- HIV/immunology
- HIV Infections/diagnosis
- Humans
- Immunophenotyping
- Kidney/parasitology
- Kidney/pathology
- Leishmania infantum/isolation & purification
- Leishmaniasis, Visceral/complications
- Leishmaniasis, Visceral/diagnosis
- Leishmaniasis, Visceral/drug therapy
- Liver/parasitology
- Liver/pathology
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/pathology
- Macrophages/parasitology
- Male
- Middle Aged
- Multimodal Imaging
- Phosphorylcholine/analogs & derivatives
- Phosphorylcholine/therapeutic use
- Positron-Emission Tomography
- Splenic Neoplasms/complications
- Splenic Neoplasms/diagnosis
- Splenic Neoplasms/pathology
- Tomography, X-Ray Computed
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40
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Medina-Franco H, Feria-Bernal G, Sánchez-Ramón A. Malignant insulinoma presenting as upper gastrointestinal bleeding. Am Surg 2012; 78:E235-E237. [PMID: 22472386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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41
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Koiso H, Yokohama A, Mitsui T, Saitoh T, Handa H, Murakami H, Hirato J, Kojima M, Nojima Y, Tsukamoto N. Follicular lymphoma presenting with marked splenomegaly: report of three cases. Acta Haematol 2012; 128:47-52. [PMID: 22614761 DOI: 10.1159/000337037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 01/30/2012] [Indexed: 11/19/2022]
Abstract
Marked splenomegaly as the main presenting sign in follicular lymphoma (FL) is rare. The clinical and morphologic findings of 3 FL patients with massive splenomegaly and slight or no lymphadenopathy are presented. All cases had massive splenomegaly, and 2 had minimal peripheral lymphadenopathy with bone marrow infiltration, which is the major involved site besides the spleen. Histologically, various sizes of micronodules, composed of medium-sized centrocytes, were present in the white pulp in 2 cases in whom splenectomy was performed. The other case was complicated by nephrotic syndrome and showed aggregates of packed small lymphocytes in the spleen and renal parenchyma. Tumor cells were positive for CD10, CD20, bcl-2, and bcl-6. Since these cases are clinically similar to splenic marginal zone lymphoma, recognition of this disease and selection of the appropriate therapy are needed.
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42
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43
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Carta G, D'Alfonso A, Nallbani A, Palermo P, Franchi V, Patacchiola F. Spontaneous rupture of splenic hemangioma in puerperium. CLIN EXP OBSTET GYN 2012; 39:407-408. [PMID: 23157060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Atraumatic splenic rupture is a rare clinical entity and in the absence of trauma, the diagnosis and treatment are often delayed. In this article the authors discuss a case of a 45-year-old woman, gravida 5, para 4, with spontaneous splenic rupture on her second postpartum day. The rupture was related to a splenic hemangioma that is a vascular malformation and the most common neoplasm of the spleen. Despite the fact that hemangiomas are the most common primary neoplasms of the spleen, only few cases of splenic rupture have been described in pregnancy or puerperium. However, spontaneous splenic rupture is a rare event and the rupture should be suspected in woman with unexplained abdominal pain or with clear signs of haemorrhage.
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44
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Tsutsumi N, Kawanaka H, Yamaguchi S, Sakai M, Momosaki S, Endo K, Ikejiri K. Huge inflammatory pseudotumor of the spleen with postoperative portal vein thrombosis: report of a case. Surg Today 2011; 42:382-5. [PMID: 22160356 DOI: 10.1007/s00595-011-0081-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 03/24/2011] [Indexed: 11/26/2022]
Abstract
We report the rare case of a splenic inflammatory pseudotumor associated with massive splenomegaly, diagnosed after surgery. A 51-year-old woman was admitted to our hospital for investigation of anemia. Physical examination revealed a palpable left upper quadrant mass. Computed tomography and magnetic resonance imaging showed a splenic mass, 20 cm in diameter. We performed splenectomy for both diagnosis and treatment. The spleen weighed 2400 g, and histologic examination of the mass confirmed an inflammatory pseudotumor. Portal vein thrombosis (PVT) developed the day after surgery, but resolved with anticoagulation therapy. This case highlights that there is a risk of PVT after splenectomy in patients with massive splenomegaly, and that anticoagulant therapy should be initiated promptly.
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45
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Gasperini ML, Gigante A, Barbano B, Liberatori M, Cianci R, Amoroso A. Acute renal failure and hypercalcemia as onset in splenic lymphoma. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2011; 15:848-850. [PMID: 21780556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Hypercalcemia is a rare metabolic disorder in course of B cell lymphoma. The mechanism of hypercalcemia in patients with malignancy may include the increased extrarenal production of vitamin D from tumoral cells or neighboring macrophages, i-PTH or PTHrP from tumoral cells. In this case we reported a 34 years old caucasian woman with acute renal failure and hypercalcemia as onset of splenic lymphoma in absence of abnormal levels of serum vitamin D and PTHrP. Because of dramatic recovery of renal function and hypercalcemia after splenectomy, we can speculate that main mechanism of hypercalcemia is related to vitamin D production from neighboring lymphoma macrophages.
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MESH Headings
- Acute Kidney Injury/blood
- Acute Kidney Injury/etiology
- Adult
- Biomarkers/blood
- Biopsy
- Calcitriol/blood
- Calcium/blood
- Chemotherapy, Adjuvant
- Creatinine/blood
- Female
- Humans
- Hypercalcemia/blood
- Hypercalcemia/etiology
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/surgery
- Parathyroid Hormone/blood
- Splenectomy
- Splenic Neoplasms/blood
- Splenic Neoplasms/complications
- Splenic Neoplasms/diagnosis
- Splenic Neoplasms/surgery
- Tomography, X-Ray Computed
- Treatment Outcome
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46
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Xu GP, Shen HF, Yang LR, Ma Q, Gao BL. Splenic cystic lymphangioma in a young woman: case report and literature review. Acta Gastroenterol Belg 2011; 74:334-336. [PMID: 21861320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Splenic cystic lymphangioma is extremely rare, with very few cases reported until now. Here, we report a case of cystic lymphangioma of the spleen in a young woman who was admitted for evaluation of abdominal pain and a mass lasting for two years. We present this case with emphasis on the problem of differential diagnosis and the difficulties of diagnostic certainty in the absence of histologic features.
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47
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Takamatsu T, Toukai K, Ikeda M, Ushimaru S, Asano T, Matsumoto N, Iwaki T, Fukunishi M, Sagihara N, Miyatani H, Yoshida Y, Yamada S. [A case of primary splenic angiosarcoma with intraperitoneal hemorrhage treated by transcatheter arterial embolization]. NIHON SHOKAKIBYO GAKKAI ZASSHI = THE JAPANESE JOURNAL OF GASTRO-ENTEROLOGY 2011; 108:658-664. [PMID: 21467774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Splenic tumors are very rare. In Japan only 42 cases of splenic angiosarcoma have been reported. We encountered a case of spontaneous rupture of a splenic angiosarcoma and liver metastasis. A 60-year-old woman who suddenly went into hemorrhagic shock presented at our hospital. Then acute spontaneously ruptured spleen and hepatic tumors were diagnosed by abdominal CT. After emergency TAE, the patient was hemodynamically stable, but died of liver failure 13 days after admission. The pathological diagnosis was primary splenic angiosarcoma with multiple organ metastasis on autopsy. Splenic angiosarcoma should be kept in mind in the differential diagnosis of splenomegaly or splenic tumor. TAE can be effective in primary hemostasis for angiosarcoma with intraperitoneal hemorrhage from multiple tumors.
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Matsuyama M, Sugiura S, Kakita A, Sato Y, Kuroda M. Hepatocellular carcinoma arising from ectopic liver tissue in the spleen producing insulin-like growth factor II. Pathol Res Pract 2010; 207:124-6. [PMID: 20943327 DOI: 10.1016/j.prp.2010.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/02/2010] [Accepted: 09/02/2010] [Indexed: 12/14/2022]
Abstract
We report a case of splenic tumor associated with severe hypoglycemia. The patient was a 69-year-old man with a large splenic tumor. He had suffered from relapsing hypoglycemic attacks and the lowest serum glucose level (4 mg/dl). He died 34 months after the onset of symptoms of left abdominal pain. Autopsy revealed large tumors in the spleen, 3 medium sized tumors in the lungs, and several small tumors in the liver. Microscopic studies of the splenic tumors revealed a hepatocellular carcinoma which showed a strongly positive reaction against anti-PIVKA-II and anti-"hepatocyte" antibodies. Several bile ductules thought to be heterotopic remnants of the liver tissues were found in the capsule of the spleen, adjoining the splenic tumor. It was suggested that the tumor originated from one of these ductules. Electron microscopic analysis showed numerous endocrine-like granules of every tumor cell, and 87-165 times stronger mRNA expression of insulin-like growth factor-II was measured in the tumor tissues when compared with normal liver tissue. Owing to these results, we believe that this is the first report of hepatocellular carcinoma that had developed from a liver tissue in the spleen.
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Jahangiri S, Mahesh S. Hepatosplenic gamma-delta T-cell lymphoma presenting with disseminated intravascular coagulation and coexistent systemic mastocytosis. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2010; 8:690-694. [PMID: 21317866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Perini G, Pro B. Hepatosplenic gamma-delta T-cell lymphoma, disseminated intravascular coagulation, and systemic mastocytosis: an unusual presentation for a rare disease. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2010; 8:693-694. [PMID: 21317867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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