Oz Puyan F, Bilgi S, Unlu E, Yalcin O, Altaner S, Demir M, Cakir B
Department of Pathology, Trakya University Medical Faculty, Edirne, Turkey.
Eur J Haematol. 2004 Apr;72(4):285-91. doi: 10.1111/j.0902-4441.2003.00208.x.
Inflammatory pseudotumor (IPT) of the spleen is a rare benign tumor with unknown etiology. It causes problems in the diagnosis because of mimicking some hematopoetic malignancies. Here we report the case of a 36-yr-old woman complaining of nausea and insomnia. Laboratory investigations were limited to increase of leukocyte and thrombocyte count. Ultrasonography and magnetic resonance (MR) imaging showed circumscribed solid lobulated mass, measuring about 6.5 cm in diameter, located in the dorsal region of the spleen. Splenectomy was performed with the differential diagnosis including hamartoma and lymphoma of the spleen. Histological examination of the sharply demarcated splenic mass consisted of myofibroblasts and admixture of inflammatory cells. Immunohistochemistry and in situ hybridization were performed. IPT of the spleen was diagnosed. Epstein-Barr virus (EBV) was detected in the tumor by in situ hybridization. This rare entity is presented because of its clinical, radiological and pathological difficulties in the differential diagnosis.
脾脏炎性假瘤(IPT)是一种病因不明的罕见良性肿瘤。由于它可模仿一些血液系统恶性肿瘤,给诊断带来困难。在此,我们报告一例36岁女性患者,主诉恶心和失眠。实验室检查仅显示白细胞和血小板计数升高。超声检查和磁共振(MR)成像显示脾脏背侧区域有一个边界清楚的实性分叶状肿块,直径约6.5厘米。进行了脾切除术,鉴别诊断包括脾脏错构瘤和淋巴瘤。对边界清晰的脾脏肿块进行组织学检查,发现由肌成纤维细胞和炎性细胞混合组成。进行了免疫组织化学和原位杂交检查。诊断为脾脏IPT。通过原位杂交在肿瘤中检测到爱泼斯坦-巴尔病毒(EBV)。由于其在鉴别诊断中存在临床、放射学和病理学困难,故报道这一罕见病例。