1/133. Inflammatory pseudotumor of the spleen associated with a cavernous hemangioma diagnosed at intra-operative cytology: report of a case and review of literature.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.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/133. Ruptured primary splenic angiosarcoma into the colon. Presentation as anal bleeding.A 71-year-old woman presented with a six month history of constipation and abdominal discomfort, with anal bleeding during the last days. ultrasonography and CT-scan of the abdomen showed a large heterogeneous mass that was located in the splenic region, but the nature and origin of the tumour could not be clearly established preoperatively. The clinical diagnosis was of abdominal tumour with colonic and splenic involvement, and a left hemicolectomy and splenectomy were performed. Pathologic examination revealed a primary angiosarcoma of the spleen with penetration and fistulization of the tumour into the large bowel. The patient received adjuvant radiation therapy, but she died of extensive metastastic disease from her primary angiosarcoma of the spleen nine months after surgery. In summary, splenic angiosarcoma is very difficult to diagnose preoperatively. This highly aggressive neoplasm has an overall poor prognosis, specially if it is associated with rupture and haemoperitoneum. As this case highlights, unusual forms of rupture may lead to atypical clinical presentations, increasing even more the difficulty in the diagnosis.- - - - - - - - - - ranking = 301.82756787465keywords = neoplasm (Clic here for more details about this article) |
3/133. Pleomorphic large cell sarcoma of the spleen with rhabdomyosarcomatous differentiation.An unusual case is reported of pleomorphic large cell sarcoma of the spleen with rhabdomyosarcomatous differentiation in a 34-year old male. According to our knowledge, such a neoplasm has never been reported in the literature.- - - - - - - - - - ranking = 301.82756787465keywords = neoplasm (Clic here for more details about this article) |
4/133. Benign vascular neoplasms of the spleen with myoid and angioendotheliomatous features.AIMS: To present the clinical light microscopic and immunophenotypic features of a distinctive vascular neoplasm of the spleen. methods AND RESULTS: Two of the splenic lesions arose in children, and one was found in an adult. They ranged from 19 to 40 mm diameter and histologically were quite similar. Sheets of large epithelioid cells with a spectrum of nuclear configurations ranging from oval and vesicular to twisted and hyperchromatic were noted in each case. Distinct or prominent nucleoli were present in many cells, and occasional cells had nuclear pseudoinclusions. In two cases, bands of basophilic, fibroblast-rich stroma with scattered chronic inflammatory cells were present. The mitotic rate ranged from 0/10 high-power fields (HPF) to 0.5/10 HPF in these epithelioid cells. The vascular nature of these tumours was manifested as a sieve-like array of round, erythrocyte-filled spaces, most with attenuated and cytologically bland lining cells. The polygonal, epithelioid cells exhibited the following phenotype: smooth muscle actin (SMA) , muscle specific actin (MSA) , vimentin , CD31-, CD34-, CD21-, CD8-, CD68- (2/3 cases), S100-, while the lining cells were CD34 , vimentin and SMA-, with variable CD31 and factor viii related antigen expression. Elongated SMA , MSA cell processes were evident in one case, reminiscent of previously characterized myoid elements of the normal spleen. An uneventful follow-up was noted for all three patients. CONCLUSIONS: The histology and immunophenotype set these neoplasms apart from classic hamartomas, haemangiomas and previously characterized (haem)angioendotheliomas of the spleen, and may represent proliferations of myoid elements native to the spleen.- - - - - - - - - - ranking = 1812.9654072479keywords = neoplasm, muscle (Clic here for more details about this article) |
5/133. Solitary splenic recurrence of ovarian cancer: case report and review of the literature.We report a rare case of solitary recurrence of ovarian cancer in the spleen which developed 4 years after initial treatment. Only six cases have been reported in the literature and all were serous carcinoma. Our patient had a splenectomy without any complications but developed a liver metastasis 10 months after splenectomy.- - - - - - - - - - ranking = 776.82630551449keywords = cancer (Clic here for more details about this article) |
6/133. Primary splenic angiosarcoma: case report and literature review.Angiosarcoma of the spleen is a rare neoplasm. We describe the clinical findings of an index case at our institution and the results of a literature review of the topic. Generally, this cancer has a poor prognosis and prompt splenectomy offers the only cure, as the cancer is poorly responsive to adjuvant chemotherapy.- - - - - - - - - - ranking = 612.55809008045keywords = neoplasm, cancer (Clic here for more details about this article) |
7/133. Solitary metachronous splenic metastases: an evaluation of surgical treatment.Splenic metastases occurring after primary tumor removal and apparently solitary have been documented only recently in literature. They are, most of the times, clinically asymptomatic and their presence is casually determined by ultrasonographic follow-up in subjects otherwise in good conditions. The belief that splenic metastases occur only in disseminated cancer is today no longer accepted. Some Authors consider solitary splenic metachronous metastases eligible for surgical treatment as well as pulmonary or hepatic metastases. In the case presented, surgery was required due to abscess formation of a splenic metastasis, which was not responding to chemotherapy. Our experience, like others reported in literature, verified a long-term post-operative survival in spite of limited disease-free time. Surgical treatment by splenectomy can be indicated in selected patients, considering that chemotherapy has been proved to be ineffective in the treatment of splenic metastases.- - - - - - - - - - ranking = 155.3652611029keywords = cancer (Clic here for more details about this article) |
8/133. Splenic smooth-muscle tumors in children with acquired immunodeficiency syndrome: report of two cases of this unusual location with evidence of an association with Epstein-Barr virus.Smooth-muscle neoplasms are rarely located in the spleen. They have been previously reported in five cases of children with human immunodeficiency virus (hiv) infection/acquired immunodeficiency syndrome (AIDS). Two cases of children with hiv infection/AIDS with autopsy and surgical pathology evidence of multiple smooth-muscle neoplasms with splenic involvement are presented. dna was extracted from histology slides in both cases for analysis for Epstein Barr (EB) virus. In both cases, the presence of EB virus was confirmed. This paper documents two additional cases of the unusual phenomenon of splenic involvement by smooth-muscle neoplasms in the setting of AIDS in childhood and further supports the role of EB virus in the development of these neoplasms.- - - - - - - - - - ranking = 1214.3102714986keywords = neoplasm, muscle (Clic here for more details about this article) |
9/133. Case of spontaneous regression of metastatic lesions of leiomyosarcoma of the esophagus.A rare case of spontaneous regression of esophageal leiomyosarcoma is reported. A 63-year-old woman underwent esophagectomy and reconstruction at our hospital after diagnosis of leiomyosarcoma. Nineteen months after esophagectomy, a coin lesion was detected in the right lung and right thoracotomy revealed pleural dissemination. The lesion in the right lung was resected and was confirmed histologically as recurrence of leiomyosarcoma. During further surgery, metastatic lesions were found in the spleen and pleura. However, all metastatic lesions were found to decrease without any anti-cancer therapy.- - - - - - - - - - ranking = 155.3652611029keywords = cancer (Clic here for more details about this article) |
10/133. Malignant melanoma with liver and spleen metastases: case report.CONTEXT: The diagnosis of primary melanoma is easily confirmed after histological analysis of the lesion, whereas it is rarely diagnosed when the patient even has distant metastases. DESIGN: Case report CASE REPORT: Malignant melanoma is responsible for about 1% of all deaths caused by cancer in the USA and only 3% of all malignant skin diseases. Malignant melanoma is a rare disease, although it corresponds to 65% of all deaths caused by skin cancer. The liver and spleen are rarely the first sites of melanoma metastases. This paper reports on the clinical picture of a patient with fatal malignant melanoma and hepatic and spleen metastases. As this was an un-usual presentation, the melanoma diagnosis could only be made after pathological analysis of the skin and hepatic lesions.- - - - - - - - - - ranking = 310.7305222058keywords = cancer (Clic here for more details about this article) |
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