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.

Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

“…Results with interferon gamma release assays have shown that the yield of this test is poor in patients with altered immune systems and this was done in our patient [12] . In most cases, IPT of the spleen affects patients in their fifth or sixth decade of life, with men and women being affected in the same proportion [1] , although some authors report a higher incidence in women [1,2] . Patients with IPT of the spleen present with unspecific symptoms, and the diagnosis is most often the result of an incidental finding.…”

“…Less frequently, fever of unknown origin, anaemia and weight loss [2] , thrombocytosis, polyclonal hypergammaglobulinemia, hypercalcemia and lekocytosis all of which suggest a lymphoproliferative disorder [13,14] may be reported. Physical examination can reveal splenomegalia, but findings are most often unspecific Preoperative diagnosis is troublesome, and can not be made by relying on laboratory findings [1] although leukocytosis and an elevated erythrocyte sedimentation rate are common. Radiological studies reveal focal necrosis, cystic calcification and myxoid changes.…”

“…Slow-growing, these tumors may be located in the lung, respiratory tract, gastrointestinal tract, liver, spleen or lymph nodes,but the liver is the most common extra pulmonary site [1,2] . About one half of the lesion is discovered incidentally during revision for other malignancies after splenectomy [1] . The aetiology and pathogenesis of IPT are not yet understood.…”

“…We report a case of a spleen IPT associated with splenic tuberculous lymphadenitis in a 50-year-old female patient who was preoperatively diagnosed with a malignant spleen neoplasm [1,2] .…”

“…Inflammatory pseudotumours (IPT) characterized microscopically by a proliferation of inflammatory cells, are infrequently found in the spleen and there are only sporadic case reports and short case series in the literature [1] . We report a case of a spleen IPT associated with splenic tuberculous lymphadenitis in a 50-year-old female patient who was preoperatively diagnosed with a malignant spleen neoplasm [1,2] .…”