Inflammatory pseudotumor of spleen: a case report

Pseudotumor inflammatory of the spleen: A rare entity with diagnostic and therapeutic challenges: A case report

INTRODUCTION AND IMPORTANCE

Inflammatory pseudotumor (IPT) of the spleen is a rare entity that can be difficult distinguishing it from malignancies, both in clinical presentation and radiological imaging.

CASE PRESENTATION

We present the case of a 43-year-old female presented with 15-cm left hypochondrial mass, Initial imaging studies raised concerns of malignancy, leading to a splenectomy. However, the final pathological examination determined that the patient had IPT of the spleen with focal expression of Smooth Muscle Antibody (SMA).

CLINICAL DISCUSSION

This case highlights the importance of considering IPT as a potential diagnosis of splenic masses that was difficult to diagnose before surgery.

CONCLUSION

The uniqueness of the case under consideration lies in the rarity and the atypical localization of IPT of the spleen.

Hepatic inflammatory myofibroblastic tumor: A case report

BACKGROUND

Hepatic inflammatory myofibroblastic tumor (HIMT) is a rare type of hepatic tumor. It is always misdiagnosed and mistreated because it is primarily found with no obvious specific manifestation, and its imaging findings are diverse.

CASE SUMMARY

Here, we report a case of HIMT that was initially diagnosed as liver malignancy but was confirmed as HIMT by histopathology after hepatectomy. Mostly, HIMTs are infiltrated with plasma cells and stain positively for anaplastic lymphoma kinase on immunohistochemistry as well as for some other kinases.

CONCLUSION

HIMT can be treated with single nonsteroidal anti-inflammatory drugs and without surgery when it is diagnosed accurately. Because the etiology of HIMT is unknown and the diagnosis is difficult, the pathogenesis and clinical process need to be further studied.

Controversies in the Spleen: Histiocytic, Dendritic, and Stromal Cell Lesions

Histiocytic, dendritic, and stromal cell lesions that occur in the spleen are challenging diagnostically, not well studied due to their rarity, and therefore somewhat controversial. New techniques for obtaining tissue samples also create challenges as splenectomy is no longer common and needle biopsy does not afford the same opportunity for examination of tissue. Characteristic primary splenic histiocytic, dendritic, and stromal cell lesions are presented in this paper with new molecular genetic findings in some entities that help differentiate these lesions from those occurring in non-splenic sites, such as soft tissue, and identify possible molecular markers for diagnosis.

Inflammatory myofibroblastic tumor of the spleen: a case report and review of the literature

Inflammatory myofibroblastic tumor of the spleen (IMTS) is an extremely rare, intermediate malignant tumor with unclear etiology, and is most frequently detected incidentally. IMTS presents with nonspecific symptoms that pose a diagnostic challenge to clinicians or presents with the similar appearances to splenetic malignant neoplasms that pose a misdiagnose prior to surgery. Histopathology of the resected specimen remains the gold standard for diagnosing these rare splenic tumors. But these tumors may be misdiagnosed if pathologists are not familiar with the histologic pattern of their variations. In this paper we report a rare case of IMTS in a 55-year-old female admitted to the Xingtai People's Hospital affiliated to Hebei Medical University, with a mass of the spleen. The mass was identified incidentally two months ago and was initially diagnosed as a splenic lymphoma. The patient underwent laparoscopic splenectomy and the histologic study of the specimen revealed findings consistent with IMTS. Histological examination of the nodular growth revealed spindle cells in a hyalinized stroma with inflammatory infiltration of predominantly plasma cells and lymphocytes, coupled with lymphoid follicle structures. Immunohistochemical staining was performed to confirm the diagnosis of IMTS. Splenectomy is both diagnostic and curative for IMTS, and prognosis is generally favorable following the procedure. Our case report of IMTS adds to pathologists' knowledge of diagnosis. Meanwhile, the description and the review of features of IMTS, based on published cases, should help to improve the understanding and diagnosis level of this rare disease.

Computed Tomography and Magnetic Resonance Imaging Findings of Inflammatory Pseudotumors in the Abdomen and Pelvis: Current Concepts and Pictorial Review

The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting. Radiologists should be aware of this group of entities, as a preoperative histopathologic diagnosis upon radiological suspicion may help to differentiate IPTs from malignancy and to allow the most appropriate clinical work-up for these patients.

Inflammatory Pseudotumor of the Spleen

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.