Splenic hamartoma: A case report and review of the literature

Abstract

Splenic hamartoma is a rare benign malformation, composed of an anomalous mixture of normal splenic elements, often found incidentally while working up other complaints or at autopsy. A splenic mass was incidentally found while evaluating the effects of a traffic accident in a 63-year-old woman. Abdominal computed tomography revealed a well-defined splenic mass with rim enhancement. The patient underwent splenectomy. The resected spleen contained a well-defined mass lesion measuring 3.5 cm × 3.0 cm. Microscopic examination revealed disorganized slit-like vascular channels lined by plump endothelial cells without atypia. The cells lining the vascular channels were positive for CD8, CD31, CD34 and vimentin. Endothelial cells that are positive for CD8 are a key feature that differentiates hamartoma from other vascular lesions of the spleen. Although this tumor is very rare, it must be included in the differential diagnosis of splenic mass-forming lesions.

Keywords: Hamartoma; Malformation; Spleen; Splenoma.

Figure 1

Abdominal computed tomography scan revealing a homogeneous round splenic mass with rim enhancement.

Figure 2

A well-defined homogeneous red-tan mass can be seen on the cut surface compressing the adjacent normal splenic parenchyma.

Figure 3

Pathological findings: Hematoxylin-eosin staining and immunohistochemical stainings. A: The tumor contains haphazardly arranged small slit-like vascular spaces lined by plump endothelial cells; B: The endothelial cells lining the vascular channels are positive for CD8; C: CD31; D: Vimentin.