Document Detail


Inflammatory pseudotumor of the spleen associated with a cavernous hemangioma diagnosed at intra-operative cytology: report of a case and review of literature.
MedLine Citation:
PMID:  10218139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This report presents a case of a 40 year old Caucasian female with a 15 cm inflammatory pseudotumor (IPT) of the spleen with associated areas of splenic hemangioma of the cavernous type. Abdominal CT showed a largely fatty splenic mass with enhancing septations, and scattered calcifications, and a small density in the liver. Grossly, the splenic lesion showed a lobulated cut surface with areas of myxoid change, necrosis, hemorrhage and cystic softening. The diagnosis of IPT was suggested at intraoperative consultation using cytologic smears and was, subsequently confirmed on permanent sections. Histologically, the lesion consisted of a densely collagenized spindle cell stroma with patchy aggregates of lymphocytes and plasma cells, and scattered foci showing hemosiderin-laden macrophages extracellular calcium deposits and osseous metaplasia. The stromal spindle cells were immuoreactive for smooth muscle actin and vimentin confirming their myofibroblastic phenotype. There were extensive areas of infarction within the mass. The patient, however, remained asymptomatic preoperatively. Histologic analysis in this case raises the possibility that low grade, perhaps repetitive, trauma to the hemangioma may have resulted in intralesional hemorrhages which, through a process of organization, may have evolved into this sizable inflammatory pseudotumor. In addition, this report reviews the current literature on the clinical significance and presentation, morphologic and immunohistochemical findings, prognosis, differential diagnosis, pathogenesis and therapy of the splenic IPT.
Authors:
A Nasir; S S Budhrani; G H Hafner; M K Sidawy; H E Kaiser
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  In vivo (Athens, Greece)     Volume:  13     ISSN:  0258-851X     ISO Abbreviation:  In Vivo     Publication Date:    1999 Jan-Feb
Date Detail:
Created Date:  1999-06-28     Completed Date:  1999-06-28     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8806809     Medline TA:  In Vivo     Country:  GREECE    
Other Details:
Languages:  eng     Pagination:  87-92     Citation Subset:  IM    
Affiliation:
Department of Pathology, George Washington University, School of Medicine and Health Sciences, Washington DC 20037, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Granuloma, Plasma Cell / complications*,  pathology,  surgery
Hemangioma, Cavernous / complications,  diagnosis*,  pathology
Humans
Intraoperative Period
Splenic Diseases / complications*,  pathology,  surgery
Splenic Neoplasms / complications,  diagnosis*,  pathology
Tomography, X-Ray Computed

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