Inflammatory Pseudotumors of the Spleen

Abstract

Inflammatory pseudotumors are uncommon benign lesions that have been found in numerous organ systems. However, their appearance within the spleen is decidedly rare. Grossly, pseudotumors appear as well-circumscribed, encapsulated masses, while microscopic examination reveals a polymorphous inflammatory cell infiltrate occurring variably with granulomatous reaction, fibrosis, and cell necrosis. Because they often present either as unexplained, asymptomatic masses or with vague constitutional symptoms, splenic inflammatory pseudotumors can raise suspicion for a primary splenic neoplasm, such as lymphoma. Splenectomy is the treatment of choice.

Medical Imaging of the Spleen

“…Although inflammatory pseudotumor is considered by most pathologists to represent a reparative process of an inflammatory lesion, the cause of inflammatorypseudotumor is unknown (SAFRAN et al 1991). Histologic findings are consistent with a polymorphous inflammatory cell infiltration occurring in response to some unidentified stimulus.…”

“…These symptoms have been reported to represent a non-specific, systemic reaction to the underlying process (SAFRAN et al 1991). Laboratory data sometimes show the presence of leukocytosis.…”

“…On a cut section, inflammatory pseudotumors can appear gray, tan, pink, white or yellow, with the predominant color reflecting the more prominent aspects of the underlying histologic composition (SAFRAN et al 1991). They are generally solitary lesions, although multiple nodules have been reported.…”

“…Malignant transformation, local invasion or metastatic spread of inflammatory pseudotumors arising from any organ has never been reported; therefore, splenectomy is considered to be a complete curative procedure (SAFRAN et al 1991). Malignant transformation, local invasion or metastatic spread of inflammatory pseudotumors arising from any organ has never been reported; therefore, splenectomy is considered to be a complete curative procedure (SAFRAN et al 1991).…”

Calcified splenic metastasis from gastric carcinoma

“…Other benign tumors such as lymphangioma, vascular tumors, and fibrous tumors are uncommon. An inflammatory pseudotumor consisting of inflammatory cells has also been described [3]. Occasionally, abscesses, hematomas, and atypical infarcts can appear as complex masses simulating solid tumors.…”