A case of splenic inflammatory pseudotumor

Inflammatory Pseudotumor of the Spleen: A Case Report and Review of the Literature

The authors report the case of an inflammatory pseudotumor found incidentally in the spleen of a 53-year-old woman who had undergone splenectomy for the treatment of immune thrombocytopenic purpura. An ultrasound performed 2 months prior to the operation showed a spleen of normal size with no appreciable masses; however, gross examination of morselized splenic tissue removed by laparoscopic splenectomy revealed two small, well-circumscribed, white–tan nodules measuring 0.8 and 1.5 cm admixed with otherwise normal-appearing splenic parenchyma. Microscopically, these mass lesions were inflammatory pseudotumors composed of a variable mixture of polyclonal populations of mature lymphocytes and plasma cells with eosinophils, neutrophils, histiocytes, and fibrous tissue. This case represents a rare splenic lesion in our review of the world literature. Inflammatory pseudotumors of the spleen are usually solitary, often asymptomatic, rarely diagnosed prior to surgical removal, and characterized by a varied but uniformly benign histologic appearance. Recognition of this entity by clinicians and pathologists is important in definitively ruling out malignancy of the spleen.

Tumours of the spleen

The spleen has been considered a ‘forgotten organ’ even if it is included and well demonstrated on every CT and MRI of the abdomen. Tumours of the spleen are rare; however, radiologists need to be aware of the main tumoral features and patterns in order to try to distinguish between benign and malignant masses often discovered incidentally. The principal tumoral masses, benign (cysts, haemangiomas, litteral cell angioma, lymphangioma) and malignant (lymphoma, metastases haemagiosarcoma), are described.

A case of hemangioma accompanied by inflammatory pseudotumor of the spleen

Both hemangioma and inflammatory pseudotumor (IPT) of the spleen are rare benign mass lesions. Moreover, a splenic hemangioma accompanied by IPT is extremely rare. A 61-year-old woman who suffered from liver cirrhosis had a splenic cavernous hemangioma surrounded by granuloma. The literature on IPT of the spleen has described several possibilities of its causes; however, it is still unknown. This case was accompanied by portal hypertension due to liver cirrhosis, which may cause microrupture of hemangioma resulting in an IPT.

Sonographically guided core-needle biopsy of focal splenic lesions: report of four cases

There are few published reports about the use of splenic needle biopsies in the investigation of focal splenic lesions. We report our experience with sonographically guided core-needle biopsies of splenic lesions in 4 patients. The biopsies resulted in the following diagnoses: sarcoidosis, malignant lymphoma, infarction, and scar tissue. Surgery was avoided in the 3 patients diagnosed with sarcoidosis, infarction, and scar tissue by ruling out the possibility of a malignant splenic tumor. None of the patients experienced significant complications. We conclude that splenic core-needle biopsy is a useful and safe diagnostic tool for the evaluation of focal splenic lesions.