A Case of Inflammatory Pseudotumor in the Spleen

Abstract

A case of an inflammatory pseudotumor of the spleen is presented. A 43-year-old woman was hospitalized for a detailed examination due to pancytopenia, which was diagnosed during an examination related to left upper quadrant abdominal pain. Physical examination revealed a 2 to 3 cm splenomegaly. Reticulocyte count was 4% and erythrocyte sedimentation rate was 55 mm/h. No other important findings were noted, except for an evident increase in myeloid series and megakaryocytes (more evident in erythroid series) on bone marrow aspiration and biopsy. Computed tomography (CT) scan revealed splenomegaly and a centrally located hypodense lesion with a 92 X 86 mm axial diameter in the spleen. With a hematologic malignancy prediagnosis, a splenectomy was performed on the patient because of pancytopenia and splenomegaly. An intrasplenic, centrally located, well-limited, capsulated lesion (9.5 x 11 x 10 cm in diameter) was discovered on macroscopic examination of the material. A cellular infiltration area was seen on microscopic examination. The spleen capsule was mildly fibrotically thickened. The lesion that separated from the spleen tissue consisted of diffusely proliferated fusiform fibroblasts, heterogenous inflammatory cells consisting mainly of plasma cells, lymphocytes, sparse neutrophils and vascular elements. No granuloma or multinuclear giant cells were detected. Pancytopenia improved on follow-up. The patient followed up for two years, is now healthy and has no complaints.

Epstein-Barr virus-positive inflammatory pseudotumor of the spleen managed with laparoscopic splenectomy

“…An inflammatory pseudotumor is formed by fibroblasts and an irregular proliferation of inflammatory cells, consisting mainly of plasma cells, mature lymphocytes, and, rarely, eosinophils [5]. This tumor type has been detected in several locations, including the respiratory tract, gastrointestinal tract, heart, soft tissue, orbits, and lymphoid organs [6][7][8][9].…”

Epstein-Barr Virus Positive Inflammatory Pseudotumor of the Spleen: Case Report and Review of the Literature

“…IPT of the spleen are extremely rare and are frequently misdiagnosed as malignant neoplasms or other benign tumors. Until 2008, less than 85 cases have been reported in the literature and this since the initial report of two cases by Cotetingam and Jaffe in 1984 [1] [3] [5]- [8].…”

Inflammatory pseudotumor of the spleen

“…Inflammatory pseudotumor of the spleen (IPT) is a rare disease process which continues to be a challenge to diagnose. It is formed on the basis of irregular proliferation of inflammatory cells [2] . Generally these tumors have benign behavior with spontaneous regression, but occasionally they have been reported to recur, metastasize and undergo sarcomatous transformation [4] .…”