Sclerosing angiomatoid nodular transformation of the spleen: a case report

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is an uncommon primary benign condition with specific histopathological characteristics. The majority of the patients are usually asymptomatic and present for treatment after an incidental finding on a routine abdominal imaging. The differential diagnosis includes other benign tumours, as well as primary malignancy or metastases of unknown origin. We report a 55-year-old woman who was presented to the surgical team of our hospital for splenectomy after the investigation of an incidental splenic lesion led to the diagnosis of SANT. The pathology report of the specimen repeated the initial diagnosis. The patient has not yet presented any complication or recurrence of the disease 8 months after the operation. From such infrequent cases, the most valuable conclusion which can be yielded is that the more the number of patients reported, the more the knowledge about the disease is broadened.

Comparsion of Liver and Spleen Elastometry Features

The review presents data on the comparison of the features of liver and spleen stiffness measurements and those on the impact of various conditions on the measurement results (the type of a sensor used, food intake, number of measurements, patient position, breathing phase, etc.). Literature has been sought in the PubMed and eLibrary databases. In particular, the liver and spleen stiffness values vary differently at the height of inspiration and expiration. This is due to organ engorgement with a change in intrathoracic and intraabdominal pressures, as well as to a reduction in splenic arterial flow during exhalation. The review gives published data on liver and spleen stiffness values in healthy volunteers. The spleen is a stiffer organ than the liver. The different liver and spleen stiffness is explained by the features of blood supply (the spleen receives the most blood supply from the intensive-flow artery; the liver does from the portal vein). The reasons for increasing the stiffness of these organs in both health and disease are described. Estimation of liver stiffness can be used to diagnose cirrhosis and portal hypertension. That of spleen stiffness can help in the diagnosis of portal hypertension and in the indirect diagnosis of the presence of esophageal varices and the nature of a splenic lesion.

ISOLATED ENTERIC SPLENIC LESION IN AN IMMUNOCOMPETENT HOST: AN INTERESTING CASE REPORT

Splenic abscess is often an unrecognized complication of enteric fever. Diagnosis is difficult because of its rarity, insidious onset, and non-specific presentation. We report an interesting case of splenic lesion in an immunocompetent adolescent with no other comorbidities, who presented with history and clinical presentation more suggestive of tubercular etiology. However, culture from the CT-guided fine-needle aspirate grew Gram-negative bacilli, identified as Salmonella Typhi which was sensitive to ampicillin, cotrimoxazole, azithromycin, and ceftriaxone. He responded favorably with oral antibiotics without any further surgical intervention. High degree of clinical awareness with timely and appropriate microbiological evaluation helped into an early definitive diagnosis of enteric splenic abscess. This case highlights that in this era of emerging infections, we should not miss the atypical presentations of the endemic diseases. Safe and minimally invasive radiological intervention with good microbiological correlation is a successful spleen conserving treatment alternative to surgery in suitable patients of splenic abscess.

Splenic lesion mimicking breast metastasis: The first description of splenic parenchymal endometriosis

Introduction: Splenic parenchymal endometriosis has never been described to date. We report here the case of real parenchymal endometriosis of the spleen. Case description: In this case, a 54-year-old female patient presented a histologically proven metastatic recurrence of breast cancer in the internal breast chain. The CT-scan also detected a large cystic structure developed from the spleen, but non-suspected to be metastasis. The patient was treated with chemotherapy (paclitaxel) and a combination of targeted therapies (everolimus and trastuzumab). While a complete radiological and biological response was noted at 2 months, the splenic cyst gradually decreased over the years. When targeted therapies were stopped, a reincrease of the splenic lesion and de novo significant hypermetabolism of the splenic parenchyma on 18F-FDG PET scan were observed. A splenectomy was finally performed and revealed splenic parenchymal endometriosis. Conclusion: This case once again highlights the complexity of endometriosis disease, from a pathophysiological point of view, but also the difficulties of radiological characterisation, and diagnostic management.

Isolated Spleen Metastasis from Lung Adenocarcinoma: A Case Report

Solitary splenic metastasis is extremely rare with few reported cases in literature. Current study reports the case of a 74-year-old, female patient who was diagnosed isolated spleen metastasis after lung adenocarcinoma, in the postoperative course. She presented with the incidental detection of nodular liver and central splenic lesions in a follow-up abdominal computed tomography (CT) scan after 5 years from the left lower lobectomy due to lung adenocarcinoma. By MRI examination, lesion in the liver was characterized as cystic and the central splenic lesion was found having a heterogeneous hypoechoic nodular character. Tru-cutbiopsy of spleen confirmed metastasis of lung adenocarcinoma. The patient underwent splenectomy. Although liver biopsy couldn’t detect any malignant tissue, lung cancer adenocarcinoma metastasis was diagnosed in splenectomy material. Herein, we report a case of incidentally found solitary splenic metastasis, 5 years after left lobectomy for lung adenocarcinoma.

Solitary splenic metastasis in a case of treated cervical cancer: a case report

Cervical cancer is the second most common cancer among women worldwide and metastasis to the spleen is a rare entity, with only few cases being reported. The present case of a 55-year-old patient diagnosed with a splenic lesion 3 years following completion of chemotherapy combined with radiotherapy for advanced cervical cancer. The patient underwent diagnostic laparoscopy with splenectomy. The histopathological studies confirmed the presence of a metastatic squamous cell carcinoma (in a known case of treated cervical cancer). At one-year follow-up after splenectomy, the patient was free of any recurrent disease. Owing to its rarity and scant data available, detailed workup should be done whenever a solitary lesion in the spleen is detected on follow-up since splenectomy is the apt management which is instrumental in preventing further complications and improves the survival rates.

Evaluation of Nodular Splenic Lesions in 370 Small-Breed Dogs (<15 kg)

ABSTRACT Three hundred seventy small-breed dogs (&lt;15 kg) undergoing splenectomy for the presence of nodular splenic lesions were evaluated in a retrospective study to assess associations with breeds, malignancy, hemoperitoneum, and median survival time compared with previous studies. Data analyzed included signalment, histopathologic diagnosis, presence or absence of hemoperitoneum, breed associations, and survival times. In the current study, 44% (163/370) of dogs had nonneoplastic splenic lesions and 56% (207/370) had neoplastic lesions. Hemangiosarcoma was present in 27% (100/370) of splenic lesions. Hemoperitoneum was present in 31% (115/370) of dogs, and of this population, 66% (76/115) had malignant splenic lesions. The most common breeds were miniature schnauzers, dachshunds, and beagles, with beagles exhibiting a positive association with malignancy. The presence of hemoperitoneum was associated with malignancy. Distribution for nodular splenic lesions, correlation of hemoperitoneum to malignancy, and median survival time were similar to previous reports in large-breed dogs. Small-breed dogs who present with hemoperitoneum are 2.6 times more likely to have a diagnosis of a malignant splenic lesion. The most common small-breed dogs with nodular splenic lesions were miniature schnauzers, dachshunds, and beagles. Beagles and small-breed terriers were more likely to have malignant splenic lesions, and small-breed terriers were more likely to present with hemoperitoneum.