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2.
Clin Nucl Med ; 45(1): e20-e23, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31306197

RESUMO

Some patients with splenic angiosarcoma initially manifest thrombocytopenia owing to hypersplenism or tumor-related bone marrow fibrosis. The diagnosis of bone marrow metastasis in patients with splenic angiosarcoma is challenging, as the presentation mimics idiopathic thrombocytopenic purpura or primary myelofibrosis. Our case showed diffuse FDG uptake in the vertebral bodies, sacroiliac bone, humerus, femur, and clavicles. It was pathologically diagnosed as bone marrow metastasis of splenic angiosarcoma. We believe that the heterogeneous FDG accumulation in the bone marrow, although nonspecific, can be useful for the diagnosis of the bone marrow metastasis in patients with splenic angiosarcoma.


Assuntos
Neoplasias da Medula Óssea/diagnóstico por imagem , Neoplasias da Medula Óssea/secundário , Fluordesoxiglucose F18 , Hemangiossarcoma/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Esplênicas/patologia , Humanos , Masculino , Pessoa de Meia-Idade
3.
Clin Hemorheol Microcirc ; 73(1): 65-71, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31561333

RESUMO

BACKGROUND: Frequently focal splenic lesions (FSL) - cysts, hemangioma, hamartoma, metastases or infarction amongst others - are incidentally found within the scope of the sonographic examination of the abdomen. By using native B-mode and Color Doppler the underlying entity often is not elucidated. Thus, more elaborate imaging modalities like CT and MRI scans with their associated risks are used to clarify the entity of FSL. PURPOSE: The aim of the present retrospective single-center study is to evaluate the diagnostic performance of CEUS examination for assessing splenic focal lesions by comparison with findings from CT and MRI scans. MATERIALS AND METHODS: Between 2010-2018 46 patients were included in the study. All patients underwent native B-mode, Color Doppler and CEUS after given informed consent. The applied contrast agent was a second-generation blood pool agent (SonoVue®, Bracco, Milan, Italy). CEUS examinations were performed and interpreted by a single experienced radiologist (EFSUMB Level 3). RESULTS: All patients were examined without occurrence of any side effects. In total, 53 FSL were investigated (9% traumatic vs. 91% non-traumatic). Compared to CT, CEUS showed a sensitivity, specificity, PPV, NPV of 100% for assessing infarction, hematoma, hamartoma, cystic and malignant lesions. In comparison with MRI, CEUS presented a sensitivity, specificity, PPV, NPV of 100% for evaluating pseudolesions, hemangioma, hamartoma, cystic and malignant lesions. CONCLUSION: With an excellent safety profile CEUS shows an equipollent diagnostic performance for differentiating FSL compared to CT and MRI scans.


Assuntos
Meios de Contraste/uso terapêutico , Imagem por Ressonância Magnética/métodos , Neoplasias Esplênicas/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Esplênicas/patologia , Adulto Jovem
4.
Autops. Case Rep ; 9(3): e2019100, July-Sept. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1017372

RESUMO

Primary splenic angiosarcoma (PSA) is a rare neoplasm of vascular origin associated with aggressive behavior and poor prognosis. The clinical presentation is usually non-specific and is mostly characterized by a wasting disease with anemia and splenomegaly, mimicking a wide range of entities. The authors present the case of an 80-year-old woman with cardiovascular comorbidities with a 6-month history of weight loss, fatigue, weakness, pallor, and abdominal pain. The physical examination showed massive splenomegaly and pallor. After a thorough evaluation that ruled out lymphoproliferative diseases, the working diagnosis was a myelodysplastic disorder. A few days after discharge, she returned to the emergency room with severe abdominal pain, worsening fatigue, and a remarkable pallor. Point-of-care ultrasound showed free intraperitoneal fluid. Spleen rupture was confirmed by abdominal computed tomography (CT) scan, and an emergency laparotomy with splenectomy was performed. The postoperative period was uneventful, and the patient recovered in a few days. The histopathology confirmed the diagnosis of PSA and the patient was referred to an oncological center. Two months later staging CT demonstrated liver and peritoneal metastases, and despite the chemotherapy she died 6 months after the diagnosis.


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias Esplênicas/complicações , Neoplasias Esplênicas/patologia , Hemangiossarcoma/patologia , Ruptura Esplênica/etiologia , Esplenomegalia/complicações , Evolução Fatal
5.
Presse Med ; 48(7-8 Pt 1): 842-849, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31447330

RESUMO

Hairy cell leukemia (HCL) is a well-defined entity. Proliferation with hair cells, morphological aspects of hairy cells are easy to identify. Hairy cells express markers CD11c, CD25, CD103 and CD123. In 80% of cases, a BRAFV600E mutation is highlighted. In the absence of a BRAFV600E mutation, the differential diagnosis with other hair cell proliferations can be difficult, especially with the variant form of hairy leukemia, diffuse lymphoma of the red pulp of the spleen or splenic lymphoma of the marginal zone. Purine analogues (PNA) with or without anti-CD20 antibodies remain the first-line reference treatment. In case of relapse or resistance to PNA, BRAF inhibitors, with or without MEK inhibitors, are proposed in patients with the mutation. In the absence of BRAFV600E mutation, moxetumomab-pasudotox represents an interesting alternative. A multidisciplinary discussion is always necessary. In complex cases, expert advice is desirable.


Assuntos
Leucemia de Células Pilosas , Linfócitos B/patologia , Proliferação de Células , Diagnóstico Diferencial , Humanos , Leucemia de Células Pilosas/diagnóstico , Leucemia de Células Pilosas/epidemiologia , Leucemia de Células Pilosas/patologia , Leucemia de Células Pilosas/terapia , Linfoma de Zona Marginal Tipo Células B/patologia , Fatores de Risco , Baço/patologia , Neoplasias Esplênicas/patologia
6.
Presse Med ; 48(7-8 Pt 1): 859-870, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31447331

RESUMO

Non-follicular small cell lymphomas include several entities whose clinical and pathological descriptions have been refined in the last 20 years. MALT lymphoma, developed at the expense of lymphoid tissue associated with the mucosa, is usually localized to a given organ, but can also disseminate. Some patients with MALT lymphoma can be treated by eradicating the associated infectious agent, whereas local treatment should be preferred for other cases ; disseminated forms and relapsed patients are eligible for anti-CD20 antibodies associated with cytotoxic agents. Patients with mantle cell lymphoma have benefited from many advances, including the use of cytarabine and bendamustine, anti-CD20 antibodies, intensive treatments (autograft) and recently targeted therapy (ibrutinib, inhibitor or the Bruton tyrosine kinase). Patients with splenic nodal marginal zone lymphomas should be evaluated for different options, of which immunochemotherapy remains important. For all these entities, the implementation of treatments may be delayed by several years for certain groups of patients. Although considered as incurable, the prognosis of these pathologies has improved significantly and the majority of patients will be able to live for many years with often treatment-free intervals.


Assuntos
Linfoma de Zona Marginal Tipo Células B , Fatores Etários , Idade de Início , Anticorpos Monoclonais/uso terapêutico , Diagnóstico Diferencial , Humanos , Imunoterapia/métodos , Imunoterapia/tendências , Linfoma de Zona Marginal Tipo Células B/classificação , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/epidemiologia , Linfoma de Zona Marginal Tipo Células B/terapia , Terapia de Alvo Molecular/métodos , Terapia de Alvo Molecular/tendências , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/terapia , Medicina de Precisão/métodos , Medicina de Precisão/tendências , Prognóstico , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/epidemiologia , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/terapia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapia
7.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451478

RESUMO

Spontaneous splenic rupture (SSR) is a rare but potentially life-threatening entity. It can be due to neoplastic, infectious, haematological, inflammatory and metabolic causes. An iatrogenic or an idiopathic aetiology should also be considered. Depending on the degree of splenic injury and the haemodynamic status of the patient, it can be managed conservatively. A 61-year-old man presented to the emergency department with an acute abdomen, hypovolaemic shock and clotting abnormalities. However, his focused assessment with sonography for trauma showed no evidence of an aortic aneurysm, rupture or dissection. Further investigation with a CT angiogram aorta confirmed a subcapsular splenic haematoma with free fluid in the pelvis and a mass in the superior pole of the spleen. He was diagnosed with an SSR. He was initially managed non-operatively. However, his repeat CT showed an enlarging haematoma and he underwent embolisation of his splenic artery. Ultrasound-guided core biopsy of his splenic mass confirmed the diagnosis of diffuse large B-cell lymphoma. This paper will discuss the clinical presentation, differential diagnosis and management of SSR. Furthermore, it provides an important clinical lesson to maintain a high index of clinical suspicion for splenic injury in patients presenting with left upper quadrant abdominal pain radiating to the shoulder. This case also reinforces the importance of close observation and monitoring of those individuals treated conservatively for signs of clinical deterioration.


Assuntos
Abdome Agudo , Linfoma Difuso de Grandes Células B , Baço , Neoplasias Esplênicas , Ruptura Esplênica , Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Testes de Coagulação Sanguínea/métodos , Angiografia por Tomografia Computadorizada/métodos , Diagnóstico Diferencial , Humanos , Biópsia Guiada por Imagem/métodos , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/patologia , Linfoma Difuso de Grandes Células B/terapia , Masculino , Pessoa de Meia-Idade , Administração dos Cuidados ao Paciente/métodos , Ruptura Espontânea/diagnóstico , Ruptura Espontânea/etiologia , Ruptura Espontânea/fisiopatologia , Ruptura Espontânea/terapia , Choque/diagnóstico , Choque/etiologia , Baço/diagnóstico por imagem , Baço/patologia , Baço/cirurgia , Neoplasias Esplênicas/complicações , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/terapia , Ruptura Esplênica/diagnóstico , Ruptura Esplênica/etiologia , Ruptura Esplênica/fisiopatologia , Ruptura Esplênica/terapia , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia de Intervenção/métodos
8.
J Nippon Med Sch ; 86(3): 179-182, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31292330

RESUMO

Littoral cell angioma (LCA), a rare vascular neoplasm that occurs in the spleen, is difficult to definitively diagnose preoperatively because histological examination is the only accurate means of diagnosing this condition. Thus, the preoperative diagnosis is often incorrect. Splenectomy is the appropriate treatment and can be performed laparoscopically or by open surgery depending on the size of the tumor. Here we present a case of a 38-year-old man who presented with a history of slight non-specific abdominal distension for 2 months. An abdominal CT scan showed a huge spleen measuring 35×18 cm and containing multiple lesions, the largest being 11.3×9.2 cm. The patient underwent open splenectomy and recovered well. Histological examination showed LCA of the spleen. To our knowledge, this is the largest reported LCA thus far and may advance our understanding of this condition.


Assuntos
Hemangioma/patologia , Hemangioma/cirurgia , Baço/diagnóstico por imagem , Baço/patologia , Esplenectomia/métodos , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Adulto , Seguimentos , Hemangioma/diagnóstico por imagem , Humanos , Masculino , Neoplasias Esplênicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento
9.
Histopathology ; 75(5): 746-754, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31269535

RESUMO

AIMS: Little has been written on the frequency and nature of incidental splenic lesions diagnosed on histopathological examination of pancreatosplenectomy specimens. METHODS AND RESULTS: For 191 such specimens, incidental histological findings after haematopathologist re-review were tabulated. Cases suspicious for lymphoid malignancy underwent molecular analysis for immunoglobulin heavy and kappa light chain rearrangement. Follow-up was obtained on selected cases. In five cases (3%), the spleen was sampled but not mentioned in the original microscopic report; all were normal on re-review. Otherwise, most (171 of 186, 92%) were initially diagnosed as normal, with 160 (94%) remaining so on re-review. Findings on re-review not initially described (n = 11, 6%) included four cases with splenic morphology suspicious for possible leukaemia/lymphoma involvement. Additional findings included abscess formation, foamy macrophages, necrotising granulomas and simple cysts. Fifteen spleens were initially diagnosed as abnormal; the histopathological process was confirmed in all, including non-necrotising granulomas, cysts, Gamna-Gandy bodies, foamy macrophages, involvement by pancreatic neoplasm and involvement by known chronic lymphocytic leukaemia (CLL). Molecular analysis was performed on the five cases of known/suspected lymphoma and two were positive for monoclonal gene rearrangement, including the known CLL and a previously undiagnosed case with similar immunophenotype. CONCLUSIONS: Incidental splenic findings are not uncommon in pancreatosplenectomy specimens. While most are of limited clinical significance, low-grade lymphoproliferative disorders may go undetected if the spleen is overlooked. We recommend careful observation of splenic findings in these specimens, with a low threshold for haematopathological consultation when in doubt.


Assuntos
Leucemia Linfocítica Crônica de Células B , Transtornos Linfoproliferativos/diagnóstico , Baço/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imunofenotipagem , Achados Incidentais , Leucemia Linfocítica Crônica de Células B/diagnóstico , Leucemia Linfocítica Crônica de Células B/patologia , Linfoma/patologia , Transtornos Linfoproliferativos/patologia , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Pâncreas/cirurgia , Pancreatectomia , Estudos Retrospectivos , Baço/cirurgia , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/patologia , Adulto Jovem
11.
Medicine (Baltimore) ; 98(28): e16245, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305404

RESUMO

RATIONALE: Primary splenic angiosarcoma (PSA) is a rare mesenchymal malignancy of the splenic vascular origin often with a dismal prognosis. Genomic profile may provide evidence for the solution of therapy. PATIENT CONCERNS: We reported a case of a 51-year-old woman with splenectomy 4 years ago and the postoperative histopathology diagnosis revealed "splenic hemangioma" with spontaneous rupture. Two years after the operation, the patient's rechecked abdominal computed tomography (CT) showed multiple hepatic occupations. DIAGNOSES: Pathological test suggested PSA hepatic metastasis. INTERVENTIONS: The patient was treated with trans-catheter arterial chemoembolization (TACE) and a pathological diagnosis of PSA was highly suspected in the hepatic biopsy. Four somatic alterations, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), Fos proto-oncogene, AP-1 transcription factor subunit (FOS), MCL1 apoptosis regulator (MCL1), and phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) were detected in the tumor tissue using a Next generation sequencing (NGS) technology. The results prompted that the patient may get clinical benefit from using some agents for targeted therapy, Everolimus, Temsirolimus, or Copanlisib. OUTCOMES: The patient refused targeted therapy. As a result, the patient passed away within 51 months after splenectomy. LESSONS: PSA is an aggressive disease that often presented with a high propensity for metastasis and rupture hemorrhage. Some of these mutations were first discovered in PSA and these findings added new contents to the genomic mutation profile of PSA.


Assuntos
Hemangiossarcoma/cirurgia , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/secundário , Esplenectomia , Neoplasias Esplênicas/cirurgia , Classe I de Fosfatidilinositol 3-Quinases/genética , Evolução Fatal , Feminino , Hemangiossarcoma/genética , Hemangiossarcoma/patologia , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Pessoa de Meia-Idade , Proteína de Sequência 1 de Leucemia de Células Mieloides/genética , Fosfatidilinositol 3-Quinases/genética , Proteínas Proto-Oncogênicas c-fos/genética , Neoplasias Esplênicas/genética , Neoplasias Esplênicas/patologia
13.
Medicine (Baltimore) ; 98(19): e15535, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083204

RESUMO

RATIONALE: Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare disease originating from dendritic cells (DCs). There are few cases report interdigitating dendritic cell sarcoma of spleen along with their pathological characteristics and treatment. PATIENT CONCERNS: Here we report a case of IDCS in 53-year-old female who presented spleen enlargement and thrombocytopenia. DIAGNOSES: The patient underwent surgical resection of spleen, and the pathology confirmed IDCS. INTERVENTIONS: She received surgical resection of spleen and one cycle of chemotherapy (ABVD with ifosfamide and oxaliplatin) after surgery. OUTCOMES: She died of severe hepatic failure caused by chemotherapy. DISCUSSION: IDCS is a rare disease with insufficient treatment guidelines. We adopted chemotherapy of ABVD with ifosfamide and oxaliplatin which showed no improvement but led to life-threatening liver damage.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Sarcoma de Células Dendríticas Interdigitantes/terapia , Falência Hepática/induzido quimicamente , Neoplasias Esplênicas/terapia , Bleomicina/efeitos adversos , Dacarbazina/efeitos adversos , Sarcoma de Células Dendríticas Interdigitantes/diagnóstico , Sarcoma de Células Dendríticas Interdigitantes/patologia , Doxorrubicina/efeitos adversos , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Baço/patologia , Esplenectomia , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/patologia , Vimblastina/efeitos adversos
14.
J Am Anim Hosp Assoc ; 55(4): 194-200, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31099606

RESUMO

This retrospective study evaluated the postoperative outcome and clinical parameters associated with prognosis in 167 client-owned dogs with 167 hemangiopericytomas. Parameters that were reviewed for an association with long-term outcome included signalment, clinical history, results of staging tests, tumor and surgical variables, and administration of adjunctive therapy. History of previous surgery, type of surgery performed, status of surgical margins, tumor location, and whether adjunctive therapy was performed were associated with tumor recurrence. The distal forelimb was the most common location reported overall (46/167 [27.5%]). Dogs with tumors located at the tail/perineum had the fastest recurrence rate, with a median disease-free interval of ∼16 mo (505 days). Tumor grade alone was not associated with recurrence (P = .069), but when analyzing tumor grade and margin, low-grade tumors with dirty margins had a significantly shorter time to recurrence than low-grade tumors with either clean or narrow margins. Tumor location should be considered when assessing the treatment plan and follow-up recommendations for any hemangiopericytomas. Aggressive initial surgical treatment is recommended when possible to reduce the chance of local tumor recurrence.


Assuntos
Doenças do Cão/cirurgia , Hemangiopericitoma/veterinária , Neoplasias Esplênicas/veterinária , Animais , Terapia Combinada , Intervalo Livre de Doença , Doenças do Cão/patologia , Cães , Hemangiopericitoma/patologia , Hemangiopericitoma/cirurgia , Estudos Retrospectivos , Esplenectomia/veterinária , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Resultado do Tratamento
16.
Medicine (Baltimore) ; 98(14): e15016, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946331

RESUMO

RATIONALE: Isolated splenic metastasis from colorectal cancer is very rare, as metastatic colorectal cancer involving the spleen is usually a manifestation of widely disseminated disease. Splenectomy is the best therapeutic option for this entity and probably the only chance for radical cure. PATIENT CONCERNS: A 73-year-old male presented with abdominal distension and dark red bloody stool of 6-month duration. DIAGNOSES: Synchronous isolated splenic metastasis from colorectal cancer. INTERVENTIONS: Based on multidisciplinary team (MDT) mode, the patient underwent the primary hepatic flexure tumor resection due to his poor general condition. One month after surgery the patient began treatment with Xelox (capecitabine 1000 mg/m, oxaliplatin 130 mg/m) every 3 weeks. The patient underwent isolated splenic metastasis resection successfully by laparoscopic after four courses of chemotherapy. OUTCOMES: The patient's postoperative course was uneventful and he completed four courses of postoperative chemotherapy using the original chemotherapy regimen Xelox (capecitabine 1000 mg/m, oxaliplatin 130 mg/m). The patient was subsequently followed up every 3 months and no signs of recurrence were noted in a recent examination. LESSONS: To the best of our knowledge, this is the first case report of isolated splenic metastasis from colorectal cancer in China. It is also the first case in which treatment was overseen by an MDT. The possibility of splenic metastasis should be considered in cases in which colorectal cancer is associated with a splenic lesion, despite its rarity. Splenectomy and adjuvant chemotherapy are the optimal therapeutic approaches, as such an approach prolongs survival and palliates the disease.


Assuntos
Colo Ascendente/patologia , Neoplasias do Colo/patologia , Neoplasias Esplênicas/secundário , Idoso , Humanos , Masculino , Baço/patologia , Neoplasias Esplênicas/patologia
18.
Medicine (Baltimore) ; 98(11): e14825, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30882665

RESUMO

RATIONALE: Littoral cell angioma (LCA) is a rare primary vascular neoplasm of the spleen. It can be benign or malignant. Pathology and immunohistochemistry are the gold standards for the diagnosis of LCA. Therefore, splenectomy is recommended for the purpose of diagnosis and treatment, and subsequent follow-up is necessary. There are limited reports about LCA. Here, we present a case of a female patient with LCA undergoing laparoscopic splenectomy in order to provide clinical experience in LCA treatment. PATIENT CONCERNS: A 32-year-old female attended the outpatient Department of Hepatobiliary Surgery for follow-up of hepatic hemangiomas. The patient presented with intermittent abdominal distension, which was slightly under no obvious inducement. DIAGNOSIS: Physical examination found no signs of abdominal tenderness and rebound tenderness, and liver and spleen were impalpable. The contrast-enhanced computed tomography (CT) showed multiple space-occupying lesions in the spleen, mottled low-density lesions, multiple hypoattenuating nodules with no contrast enhancement on the arterious phase. Delayed contrast-enhanced helical CT scan displayed incomplete filling of hypodense splenic lesions. INTERVENTIONS: Given that it was uncertain whether it was a benign or a malignant tumor, a laparoscopic total splenectomy was performed. OUTCOMES: The final pathological diagnosis was LCA. Her postsurgical course was uneventful, and no surgery-related complications were found. No signs of recurrence were observed in the 16 months after the operation. LESSONS: LCA was a rare primary vascular neoplasm of the spleen, and laparoscopic splenectomy for LCA was safe and feasible, and postoperative course was uneventful. However, regular follow-up and long-time monitoring after splenectomy for LCA is recommended because of its potential malignant biological behavior.


Assuntos
Hemangioma , Laparoscopia/métodos , Neoplasias Hepáticas , Esplenectomia/métodos , Neoplasias Esplênicas , Adulto , Feminino , Hemangioma/complicações , Hemangioma/patologia , Hemangioma/cirurgia , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/patologia , Baço/diagnóstico por imagem , Baço/patologia , Baço/cirurgia , Neoplasias Esplênicas/complicações , Neoplasias Esplênicas/patologia , Neoplasias Esplênicas/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
20.
Medicine (Baltimore) ; 98(9): e14555, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30817572

RESUMO

RATIONALE: Spindle cell hemangioma (SCH) is considered a benign vascular lesion. It typically develops as a solitary nodule or multiple masses located in the dermal or subcutaneous layers of the distal extremities. To the best of our knowledge, there are no prior reports of SCH in the spleen. PATIENT CONCERNS: A 41-year-old male was admitted to our hospital with recurrent headaches, nausea, and vomiting persisting for 5 days. Ultrasound, computed tomography, and magnetic resonance imaging revealed multiple space-occupying lesions in the spleen, and the biggest lesion was 4.8 cm × 5.4 cm in size. INTERVENTIONS: The patient underwent laparoscopic splenectomy. DIAGNOSIS: A diagnosis of spindle cell hemangioma of the spleen was made based on the histopathology. OUTCOMES: No evidence of local recurrence or distant metastases was observed over 4-year follow-up. LESSONS: Splenic SCH may exhibit relatively high proliferative activity and be comorbid with epithelioid hemangioendothelioma or angiosarcoma, raising the possibility of malignant potential. However, the patient remained alive and disease-free 4 years after the operation. The nature of SCH in deep soft tissues requires further study.


Assuntos
Hemangioma/patologia , Sarcoma/patologia , Neoplasias Esplênicas/patologia , Adulto , Humanos , Masculino , Baço/patologia
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