Inflammatory pseudotumor of the spleen: A case report and review of published cases

Abstract

Inflammatory pseudotumor of the spleen (IPTS) is an extremely rare condition. To the best of our knowledge, only ∼113 cases have been reported in the literature since the first 2 cases were reported in 1984. The present study reports the case of an IPTS in a 72-year-old male patient. The splenic tumor was identified incidentally 1 year prior to the patient being admitted to the Second Affiliated Hospital of Dalian Medical University (Dailan, China). There were no specific clinical symptoms. The initial diagnosis was of splenic lymphoma based on the pre-operative radiological findings. However, the patient underwent a splenectomy and the final pathological diagnosis of IPTS was declared. The present study also highlighted the difficulty of forming accurate pre-operative diagnoses, even when using modern imaging techniques. A partial resection of the spleen or splenectomy was considered to be the required treatment to form a definitive diagnosis and exclude malignancy. The prognosis of IPTS is generally considered to be favorable following splenectomy. The clinical and pathological features of previously reported cases are also briefly reviewed in the present study to aid in improving the accuracy of the diagnosis of this rare disease.

Keywords: benign tumor; inflammatory pseudotumor; misdiagnosis; spleen.

Figure 1

(A) Abdominal ultrasonography showing a single splenic mass 5.5 cm in diameter. (B) MRI showing the lesion in the upper spleen. A T1 dynamic delay phase study demonstrated enhancement of the periphery and inhomogeneous enhancement in the tumor center. (C) The resected spleen weighed 385 g and the tumor size was 7.8×6.5×5.5 cm. The tumor was circumscribed, but not encapsulated, and contained a large amount of tan-white necrotic tissue in the center. (D) Low-magnification photomicrograph of normal spleen showing mixed inflammatory infiltration, a well-defined fibrous capsule and adjacent splenic tissue with a resemblance to granulation tissue (hematoxylin and eosin staining, magnification ×100). MRI, magnetic resonance imaging.