Inflammatory pseudotumor of the spleen with EBV positivity: report of a case
M. Demir
Internal Medicine Division of Haematology, Trakya University Medical Faculty, Edirne, Turkey
Search for more papers by this authorM. Demir
Internal Medicine Division of Haematology, Trakya University Medical Faculty, Edirne, Turkey
Search for more papers by this authorAbstract:
Inflammatory pseudotumor (IPT) of the spleen is a rare benign tumor with unknown etiology. It causes problems in the diagnosis because of mimicking some hematopoetic malignancies. Here we report the case of a 36-yr-old woman complaining of nausea and insomnia. Laboratory investigations were limited to increase of leukocyte and thrombocyte count. Ultrasonography and magnetic resonance (MR) imaging showed circumscribed solid lobulated mass, measuring about 6.5 cm in diameter, located in the dorsal region of the spleen. Splenectomy was performed with the differential diagnosis including hamartoma and lymphoma of the spleen. Histological examination of the sharply demarcated splenic mass consisted of myofibroblasts and admixture of inflammatory cells. Immunohistochemistry and in situ hybridization were performed. IPT of the spleen was diagnosed. Epstein–Barr virus (EBV) was detected in the tumor by in situ hybridization. This rare entity is presented because of its clinical, radiological and pathological difficulties in the differential diagnosis.
References
- 1 Matsubara O, Tan-Liu NS, Kenney RM, Mark EJ. Inflammatory pseudotumors of the lung. Progression from organizing pneumonia to fibrous histocytoma or to plasma cell granuloma in 32 cases. Hum Pathol 1988; 19: 807–814.
- 2
Tada T,
Wakabayashi T,
Kishimoto H.
Plasma cell granuloma of the stomach.
Cancer
1984; 54: 541–544.
10.1002/1097-0142(19840801)54:3<541::AID-CNCR2820540326>3.0.CO;2-0 CAS PubMed Web of Science® Google Scholar
- 3 Garner A. Pathology of pseudotumors of the orbit. A review. J Clin Pathol 1973; 26: 639–648.
- 4 Someren A. Inflammatory pseudotumor of the liver with occlusive phlebitis. Report of a case in a child and review of the literature. Am J Clin Pathol 1978; 69: 176–181.
- 5
Horiuchi R,
Uchida T,
Kojima T,
Shikata T.
Inflammatory pseudotumor of the liver: clinicopathologic study and review of the literature.
Cancer
1990; 65: 1583–1590.
10.1002/1097-0142(19900401)65:7<1583::AID-CNCR2820650722>3.0.CO;2-L CAS PubMed Web of Science® Google Scholar
- 6 Abrebanel P, Sarfaty S, Gal R, Chainoff C, Kessler E. Plasma cell granuloma of the pancreas. Arch Pathol Lab Med 1984; 108: 531–532.
- 7 Maeda Y, Tani E, Nakano M, Matsumoto T. Plasma cell granuloma of the fourth ventricle. J Neurosurg 1984; 60: 1291–1296.
- 8 Cotelingam JD, Jaffe ES. Inflammatory pseudotumor of the spleen. Am J Surg Pathol 1984; 8: 375–380.
- 9 Kutok JL, Pinkus GS, Dorfman DM, Fletcher CD. Inflammatory pseudotumor of lymph node and spleen: an entity biologically distinct from inflammatory myofibroblastic tumor. Hum Pathol 2001; 32: 1382–1387.
- 10
Dehner LP.
The enigmatic inflammatory pseudotumors: the current state of our understanding, or misunderstanding.
J Pathol
2000; 192: 277–279.
10.1002/1096-9896(200011)192:3<277::AID-PATH749>3.0.CO;2-E CAS PubMed Web of Science® Google Scholar
- 11 Cheuk W, Woo PC, Yuen KY, Yu PH, Chan JKC. Intestinal inflammatory pseudotumor with regional lymph node involvement: identification of a new bacterium as the aetiological agent. J Pathol 2000; 192: 289–292.
- 12 Coffin CM, Watterson J, Priest JR, et al. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor): a clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol 1995; 19: 859–872.
- 13 Bostick WL. Primary splenic neoplasm. Am J Surg Pathol 1945; 21: 1143–1165.
- 14 Ozkara SK, Gurbuz Y, Ercin C, Muezzinoglu B, Turkmen M. Inflammatory pseudotumor of the spleen. Virchows Arch 2001; 438: 629–631.
- 15 Yano H, Imasato M, Monden T, Okamoto S. Inflammatory pseudotumor of the spleen: report of two cases. Surgery 2003; 133: 349–350.
- 16 Sarker A, An C, Davis M, Praprotnik D, McCarthy LJ, Orazi A. Inflammatory pseudotumor of the spleen in a 6-year-old child: a clinicopathologic study. Arch Pathol Lab Med 2003; 127: e127–e130.
- 17 Chen HD, Huang YS, Chai CY, Huang TJ. Inflammatory pseudotumor of the spleen – a case report. Kaohsiung J Med Sci 2001; 17: 441–443.
- 18 Soares Oliveira M, Carvalho JL, Estevao_Costa J, Fonseca E. Inflammatory pseudotumor of the spleen in a child. Med Pediatr Oncol 2001; 37: 77–78.
- 19 Di Vita G, Soresi M, Patti R, Carroccio A, Leo P, Franco V, Montalto G. Concomitant inflammatory pseudotumor of the liver and spleen. Liver 2001; 3: 217–222.
- 20 Neuhauser TS, Derringer GA, Thompson LD, FanburgSmith JC, Aguilera NS, Andriko J, Chu WS, Abbondanzo SL. Splenic inflammatory myofibroblastic tumor (inflammatory pseudotumor): a clinicopathologic and immunophenotypic study of 12 cases. Arch Pathol Lab Med 2001; 125: 379–385.
- 21 Moriyama S, Inayoshi A, Kurano R. Inflammatory pseudotumor of the spleen: report of a case. Surg Today 2000; 30: 942–946.
- 22 Matsubayashi H, Mizoue T, Mizuguchi Y, Shinohara Y, Magami Y, Horibe T, Seki T, Saito T, Serizawa H. A case of hemangioma accompanied by inflammatory pseudotumor of the spleen. J Clin Gastroenterol 2000; 31: 258–261.
- 23 Hrora A, Raiss M, Mahassini N et al. Inflammatory pseudotumor of the spleen. Ann Chir 2000; 125: 585–587.
- 24 Irie H, Honda H, Kuroiwa T, Yoshimitsu K, Aibe H, Tajima T, Masuda K. Pseudotumors of the spleen. JBR-BTR 2000; 83: 216–217.
- 25 Noguchi H, Kondo H, Kondo M, Shiraiwa M, Monobe Y. Inflammatory pseudotumor of the spleen: a case report. Jpn J Clin Oncol 2000; 30: 196–203.
- 26 Yamaguchi M, Yamamoto T, Tate G, Matsumoto T, Matsumiya A, Kuzume M, Sanada Y, Kumada K. Specific detection of Epstein–Barr virus in inflammatory pseudotumor of the spleen in a patient with a high serum level of soluble IL-2 receptor. J Gastroenterol 2000; 35: 563–566.
- 27 Variami E, Terpos E, Vgenopoulou S, Kanellopoulou G, Meletis J. Inflammatory pseudotumor of the spleen: a case report and review of the literature. Ann Hematol 1999; 78: 560–563.
- 28 Suga K, Miura K, Kume N, Hara A, Matsunaga N, Tangoku A, Oka M. Tc-99m colloid and Ga-67 imaging of splenic inflammatory pseudotumor correlation with ultrasound, CT, and MRI. Clin Nucl Med 1999; 24: 334–337.
- 29 Nasir A, Budhrani SS, Hafner GH, Sidawy MK, Kaiser HE. Inflammatory pseudotumor of the spleen associated with a cavernous hemangioma diagnosed at intra-operative cytology: report of a case and review of literature. In Vivo 1999; 13: 87–92.
- 30 Hayasaka K, Soeda S, Hirayama M, Tanaka Y. Inflammatory pseudotumor of the spleen: US and MRI findings. Radiat Med 1998; 16: 47–50.
- 31 Tsugawa K, Hashizume M, Migou S, Kawanaka H, Sugimachi K, Irie H, Maeda T, Akaboshi K. Laparoscopic splenectomy for an inflammatory pseudotumor of the spleen: operative technique and case report. Hepatogastroenterology 1998; 45: 1887–1891.
- 32 Dominis M, Dzebro S, Kusic B, Antica M. Inflammatory pseudotumor of the spleen. Acta Cytol 1998; 42: 1053–1056.
- 33 Madrigal B, Perez del Rio MJ, Vara A, Ablanedo P, Ovidio Gonzalez L, Florentino Fresno M. Inflammatory pseudotumor of the spleen. An old concept with many questions. Sangre (Barc) 1998; 43: 227–230.
- 34 Hayasaka K, Tanaka Y, Kawamori J. Dynamic MR imaging of splenic tumor. Comput Med Imaging Graph 1997; 21: 243–251.
- 35 Galindo Gallego M, Ortega Serrano MP, Ortega Lopez M, Esteban Collazo F, Guinea Esquerdo L. Inflammatory pseudotumor of spleen. Report of two cases and literature review. Minerva Chir 1997; 52: 1379–1388.
- 36 Parajo A, Miranda C, Otero E, Cadavid A, Garcia M, Montero M. Inflammatory pseudotumor of the spleen. Gastroenterol Hepatol 1997; 20: 449–451.
- 37 Aru GM, Abramowsky CR, Ricketts RR. Inflammatory pseudotumor of the spleen in a young child. Pediatr Surg Int 1997; 12: 299–301.
- 38 Irie H, Honda H, Kaneko K et al. Inflammatory pseudotumors of the spleen: CT and MRI findings. J Comput Assist Tomogr 1996; 20: 244–248.
- 39 Meduri S, Zuiani C, Bendini M, Bazzocchi M. The imaging diagnosis of a rare case of inflammatory pseudotumor of the spleen. Radiol Med (Torino) 1996; 91: 143–145.
- 40 Carmena J, Tornero C, Villanueva A, Pons E. Fever of unknown origin as the presenting form of an inflammatory pseudotumor of the spleen. Med Clin (Barc) 1995; 104: 515.
- 41 McHenry CR, Perzy Gall HB, Mardini G, Chung Park M. Inflammatory pseudotumor of the spleen: a rare entity that may mimic hematopoietic malignancy. Am Surg 1995; 61: 1067–1071.
- 42 Shah DJ, Royes CA. Inflammatory pseudotumour of the spleen. Report of a case and review of the literature. West Indian Med J 1994; 43: 30–31.
- 43 Glazer M, Lally J, Kanzer M. Inflammatory pseudotumor of the spleen: MR findings. J Comput Assist Tomogr 1992; 16: 980–983.
- 44 Zawirska B, Pyra Rzeszutko M, Orzel W. Inflammatory pseudotumor of spleen. Patol Pol 1993; 44: 43–44.
- 45 Natsugoe S, Ohwaki T, Tsubouti H, Mitsuda K, Maenohara S, Takao S, Aikou T, Shimazu H, Hasui K. Inflammatory pseudotumor of the spleen: report of a case. Surg Today 1993; 23: 246–250.
- 46 Iwafuchi M, Watanabe H, Maejima T, Okamura N, Miwa K. Inflammatory pseudotumor of the spleen. Report of a case with an immunohistochemical study. Acta Pathol Jpn 1992; 42: 376–381.
- 47 Shepherd JJ, Fassett RG, Challis D. Hypercalcaemia associated with inflammatory pseudotumour of the spleen. Br J Surg 1992; 79: 50.
- 48 Franquet T, Montes M, Aizcorbe M, Barberena J, Aazua YR, Cobo F. Inflammatory pseudotumor of the spleen: ultrasound and computed tomographic findings. Gastrointest Radiol 1989; 14: 181–183.
- 49 Thomas RM, Jaffe ES, Zarate-Osorno A, Medeiros LJ. Inflammatory pseudotumor of the spleen. A clinicopathologic and immunophenotypic study of eight cases. Arch Pathol Lab Med 1993; 117: 921–926.
- 50 Sheahan K, Wolf BC, Neiman RS. Inflammatory pseudotumor of the spleen: a clinicopathology study of three cases. Hum Pathol 1988; 19: 1024–1029.
- 51 Fu KH, Liu HW, Leung C. Inflammatory pseudotumors of the spleen. Histopathology 1990; 16: 302–304.
- 52
Wiernik PH,
Rader M,
Becker NH,
Morris SF.
Inflammatory pseudotumor of spleen.
Cancer
1990; 66: 597–600.
10.1002/1097-0142(19900801)66:3<597::AID-CNCR2820660332>3.0.CO;2-C CAS PubMed Web of Science® Google Scholar
- 53 Suster S, Moran CA, Blanco M. Mycobacterial spindle-cell pseudotumor of the spleen. Am J Clin Pathol 1994; 101: 539–542.
- 54 Arber DA, Kamel OW, Van de Rijn M, Davis RE, Medeiros LJ, Jaffe ES, Weiss LM. Frequent presence of Epstein–Barr virus in inflammatory pseudotumor. Hum Pathol 1995; 26: 1093–1098.
- 55 Arber DA, Weiss LM, Chang KL. Detection of Epstein–Barr virus in inflammatory pseudotumor. Semin Diagn Pathol 1998; 15: 155–160.
- 56 Gomez-Roman JJ, Sanchez-Velasco P, Ocejo-Vinyals G, Hernandez-Nieto E, Leyva-Cobian F, Val-Bernal JF. Human herpesvirus-8 genes are expressed in pulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). Am J Surg Pathol 2001; 25: 624–629.
- 57 Rohrlich P, Peuchmaur M, Cocci SN, Gasselin ID, Garel C, Aigrain Y, Galanaud P, Vilmer E, Emilie D. Interleukin-6 and interleukin-1 beta production in a pediatric plasma cell granuloma of the lung. Am J Surg Pathol 1995; 19: 590–595.
- 58 Perrone T, De Wolf-Peeters C, Frizzera G. Inflammatory pseudotumor of lymph nodes. A distinctive pattern of nodal reaction. Am J Surg Pathol 1988; 12: 351–361.
- 59 Moran CA, Suster S, Abbondanzo SL. Inflammatory pseudo-tumor of lymph nodes: a study of 25 cases with emphasis on morphological heterogeneity. Hum Pathol 1997; 28: 332–338.
- 60 Davis RE, Warnke RA, Dorfman RF. Inflammatory pseudotumor of lymph nodes. Additional observations and evidence for an inflammatory etiology. Am J Surg Pathol 1991; 15: 744–756.
- 61 Coffin CM, Humphrey PA, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor: a clinical and pathological survey. Semin Diagn Pathol 1998; 15: 85–101.