Inflammatory pseudotumor of 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.

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.

Littoral cell angioma: A case report

Primary splenic lesions are rare entities among which littoral cell angioma (LCA) is a recently described, uncommon vascular lesion that is unique to the spleen. It has heretofore been described primarily in pathologic series and has been found mostly to behave as a benign entity. A few reports of malignant variants have been reported. We present a case report of a solitary LCA discovered after splenectomy for an incidentally discovered splenic lesion, along with a literature review.

Detection of Epstein-Barr virus in inflammatory pseudotumour of the spleen: a case report

BACKGROUND

Various types of benign and malignant splenic tumours including hemangiomas, lymphagiomas, hamartomas, hemangiosarcomas, malignant lymphomas and metastatic carcinomas share radiological characteristics making it impossible for a physician to determine the definite aetiology of splenic masses noninvasively without histopathological evaluation. It is important that physicians recognize the importance of a careful and continuous follow-up since inflammatory pseudotumours (IPT) are considered to be tumours with an intermediate malignant potential based on their behaviour when they arise in other locations.

METHODS

Our patient, a 60-year-old woman was evaluated using laboratory, gastroscopy, computed tomography and surgical methods. The resected tumour was evaluated using immunohistochemical methods.

RESULTS

The patient presented with weight loss, nausea and vomiting, symptoms lasting over a course of a few months. The splenic mass was found incidentally at the time of work up for gastritis and cholelithiasis. Histologically, the tumour differed from typical splenic architecture being composed of atypical spindle cells with inflammatory elements; numerous plasma cells, macrophages, eosinophils and lymphocytes.

CONCLUSIONS

Although very difficult to diagnose at initial presentation, it is very important for the physician to be aware of the importance of a careful diagnosis since IPT of the spleen are rare and considered to be tumours with an intermediate malignant potential.

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.

Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

Inflammatory pseudotumor (IPT) of the spleen is an uncommon entity with an uncertain aetiology. Inflammatory pseudotumors present diagnostic difficulties because the clinical and radiological findings tend to suggest a malignancy. The symptoms include weight loss, fever, and abdominal pain. Most cases of splenic IPT present solitary relatively large well circumscribed masses on imaging. The diagnosis in the majority of the cases is made after histopathologic study of splenectomy specimens. The IPTs that occur in the spleen and liver are typically associated with Epstein-Barr virus. Thirty-seven percent of all new cases of active tuberculosis infection are extrapulmonary tuberculosis and tuberculous lymphadenitis the most commonly occurring form of extrapulmonary tuberculosis. We report the case of an inflammatory pseudotumor of the spleen associated with splenic tuberculous lymphadenitis in a 50-year-old female patient who was preoperatively diagnosed with a malignant spleen tumour based on her history of breast of carcinoma.