Splenic lymphangiomas

Case contributed by Dr Hani Makky Al Salam

Presentation

Abdominal pain.

Patient Data

Age: 50 years
Gender: Female
X-ray

Unremarkable. In close inspection a tiny calcific focus can be seen projecting over the spleen shadow. 

Ultrasound

Spleen is replaced by multiple cystic structures of varying size.

CT

Spleen is replaced by multiple cystic lesion of varying size. Some showed septa and mural calcifications. 

Pathology

Splenectomy macroscopic and microscopic tissue examination reveals multiple cyst in different size , some of which showed fibrosis of the wall with focal calcification. Those cyst are filled with lymphatic fluids with some lymphocytes an RBCs and lined by single layer of endothelium which stained positive for CD 31 and CD 34.

The rest of the spleen shows multiple discrete noncaseating granulomas with giant cells. No malignancy.

Diagnosis: Splenic lymphangiomas with granulomatus inflammation.

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