Fine needle aspiration biopsy of a splenic hemangioma. A case report with review of the literature.

A 33-year-old man was hospitalized for hyperpyrexia and pain in the left upper quadrant of his abdomen. Abdominal ultrasound showed a mass in the inferior pole of the spleen. A computed axial tomography of the abdomen and a liver and spleen scintigraphy confirmed a space-occupying lesion in the spleen but were not able to define its nature. A FNAB performed during abdominal ultrasound showed cells with elliptic nuclei and elongated pale blue cytoplasm, separated from each other by empty spaces of varying width. The presence of a hemangioma or lymphangioma of the spleen was suspected. A splenectomy was performed. The histologic findings were compatible with a cavernous hemangioma. After a review of the literature, the role of FNAB of the spleen is discussed as a reasonable diagnostic approach that assists the clinician in making therapeutic decisions in the management of the space-occupying lesions in the spleen. The possibility of differentiating benign from malignant lesions is pointed out, particularly those of endothelial nature. Finally, the differential diagnosis between hamartoma and hemangioma of the spleen is discussed. The two words, in times past, were often used for the same lesion, producing a confusion of names in literature.