case_images: PMC11408321_01
case_images: Preoperative examination of the patient. (A) Computed tomography scan showing a mass of about 61x15 mm in the lower pole of the spleen (red arrow). (B) Enhancement of the wall of the capsule with no obvious enhancement within the capsule is observed (red arrow). (C) The red arrow indicated the tumor. (D) Three-dimensional imaging showing the tumor confined to the lower pole of the spleen (red arrow) and supplied by the lower pole splenic artery.
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case_images: PMC11408321_01_fonc-14-1460566-g001.jpg
case_images: f1
case_images: Enhanced abdominal computed tomography (CT) revealed a mass measuring approximately 61 x 15 mm at the lower pole of the spleen, with enhancement of the wall of the capsule and no enhancement inside the capsule ( Figure 1 ). Three-dimensional reconstruction suggested that the mass was confined to the lower pole of the spleen and supplied only by the lower pole splenic artery ( Figure 1 ).
case_images: Intraoperative images. (A, B) Opening the gastrocolic ligament, suspending the stomach on the abdominal wall, and exposing the splenic hilum. (C, D) Naked inferior pole splenic artery and clamped for dissection, the red arrow indicated the inferior polar splenic artery and the white arrow indicated the superior polar splenic artery. (E) The inferior pole splenic vein branch is ligated. (F) Obvious ischemic line appearing after dissecting the inferior pole splenic vessel (red dotted line). (G) The spleen is dissected using an ultrasonic scalpel along the ischemic line 1 cm lateral to the spleen. (H) Cross-section of the spleen.
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case_images: PMC11408321_01_fonc-14-1460566-g002.jpg
case_images: f2
case_images: After completely dissecting the lower pole of the spleen, the section was repeatedly rinsed and covered with an absorbable hemostatic fiber to ensure there was no obvious blood seepage ( Figure 2 ).
case_images: Postoperative computed tomography image. The red arrow (A, B) shows the spleen section, and no perisplenic blood or fluid accumulation was observed.
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case_images: PMC11408321_01_fonc-14-1460566-g003.jpg
case_images: f3
case_images: No perisplenic blood or fluid accumulation was observed on enhanced abdominal CT ( Figure 3 ) on the 5th postoperative day, and the patient was discharged from the hospital on the 7th day after no abnormalities were found in the blood analysis, liver function, or renal function.
case_images: Pathological findings. (A)Hematoxylin and eosin staining shows a large number of cystic cavities in the middle of the spleen, filled with pink fluid and erythrocytes (x100). (B) CD31(+) (x100). (C) CD34 (partial +) (x100). (D) D2-40 (partial +) (x100).
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case_images: PMC11408321_01_fonc-14-1460566-g004.jpg
case_images: f4
case_images: The immunohistochemical staining results were as follows: D2-40 (partially +), CD31 (+), CD34 (partially +), P-CK (-), EMA (-), calretinin (-), WT-1 (-), and Ki-67 (+, approximately 2%) ( Figure 4 ).