Mance Marko, Romić Ivan, Majerović Matea
Majerović, University of Zagreb, Zagreb University Hospital Center, Kišpatićeva 12, 10000, Zagreb, Croatia.
Department of Internal Medicine, University of Zagreb, Zagreb University Hospital Center, Zagreb, Croatia.
Wien Klin Wochenschr. 2016 Jun;128(11-12):442-6. doi: 10.1007/s00508-015-0807-6. Epub 2015 Jun 25.
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.
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.
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.
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.
各种类型的良性和恶性脾脏肿瘤,包括血管瘤、淋巴管瘤、错构瘤、血管肉瘤、恶性淋巴瘤和转移性癌,具有共同的放射学特征,这使得医生在没有组织病理学评估的情况下无法通过非侵入性手段确定脾脏肿块的确切病因。由于炎性假瘤(IPT)根据其在其他部位出现时的行为被认为是具有中等恶性潜能的肿瘤,因此医生认识到仔细和持续随访的重要性非常重要。
我们的患者是一名60岁女性,采用实验室检查、胃镜检查、计算机断层扫描和手术方法进行评估。对切除的肿瘤进行免疫组织化学方法评估。
患者出现体重减轻、恶心和呕吐症状,持续数月。脾脏肿块是在对胃炎和胆结石进行检查时偶然发现的。组织学上,肿瘤与典型的脾脏结构不同,由具有炎症成分的非典型梭形细胞组成;有大量浆细胞、巨噬细胞、嗜酸性粒细胞和淋巴细胞。
尽管在初次就诊时很难诊断,但医生意识到仔细诊断的重要性非常重要,因为脾脏IPT很罕见,且被认为是具有中等恶性潜能的肿瘤。