Splenic hamartoma. A diagnostic problem on fine needle aspiration cytology.

Between 1980 and 1992, four splenic hamartomas from three patients were aspirated for cytologic diagnosis. Two patients were female and one male, with two lesions. All were seen because of hematologic problems, such as anemia and pancytopenia. Routine bone marrow study revealed normal to hypercellular marrow. Abdominal sonography revealed hypoechoic masses in the spleen. In all cases the clinical diagnosis of a malignant lymphoma was established. The smears of aspirated material showed many small and large clusters composed of large, abnormal cells that were diagnosed as metastatic tumors. Since no primary tumor sites were detected, the patients underwent splenectomy for a definitive diagnosis. Histologically the splenic masses were diagnosed as hamartomas. The source of the abnormal cells could have been endothelial cells or hematologic precursor cells, such as erythroblasts or atypical lymphocytes. The hematologic abnormalities disappeared after removal of the spleen.