Inflammatory pseudotumor of spleen. Report of two cases and literature review

Abstract

Objective: We report two new cases of inflammatory pseudotumor of the spleen and review the cases reported to date. We discuss the diagnostic value of the clinical manifestations, the modern image technics and the laboratory data and conclude that only pathological and immunohistochemical studies allow a reliable diagnosis of this disease.

Data sources: We have obtained the cases for the review through a computer search with the system SilverPlatter 3.11 (SilverPlatter Software Copyright NU 1992). The new cases have been obtained from our files.

Data synthesis: 53% were random findings (47% in the workup of another disease and 5% at autopsy). In the remaining cases, the clinical signs were not specific and none of the image technics could establish diagnosis. Neither fine needle aspiration nor laboratory data rendered conclusive results. Only pathological and immunohistochemical study after splenectomy allowed diagnosis. The clinical signs disappeared in all the cases following splenectomy and none of the patients have had recurrences.

Conclusions: Inflammatory pseudotumor is a benign disease of unknown etiology and pathogenesis. It consists of solitary or multiple tumors that can affect virtually any organ. Clinical signs are non-specific. This lesion can render diagnostic problems with neoplasms of the lymphoreticular system. Splenectomy is diagnostic and curative.