case_images: PMC11096474_01
case_images: Enhanced CT scan reveals a large amount of fluid accumulation in the abdominal cavity. Multiple low-density nodules are visible within the spleen, accompanied by uneven density below the spleen. (A, B) Multiple low-density nodules are visible within the spleen. (C, D) Uneven density changes are observed on the inner side of the spleen.
case_images: fonc-14-1366554-g001.jpg
case_images: PMC11096474_01_fonc-14-1366554-g001.jpg
case_images: f1
case_images: Initial consideration was given to intra-abdominal visceral bleeding ( Figure 1 ).
case_images: The surgically removed spleen shows an approximately 0.5cm rupture with uneven surface coloration.
case_images: fonc-14-1366554-g002.jpg
case_images: PMC11096474_01_fonc-14-1366554-g002.jpg
case_images: f2
case_images: Emergency exploratory laparotomy unveiled around 4000ml of intraperitoneal hemorrhage and an actively bleeding splenic rupture ( Figure 2 ), necessitating splenectomy.
case_images: Pathological images and immunohistochemistry staining were performed, indicating significant tumor cell heterogeneity with visible nuclear division. [(A), HEx100]; [(B), HEx200]; [(C), HEx400].
case_images: fonc-14-1366554-g003.jpg
case_images: PMC11096474_01_fonc-14-1366554-g003.jpg
case_images: f3
case_images: Considering the Hematoxylin and Eosin (HE) staining ( Figure 3 ) and immunohistochemical markers, the primary consideration is a vascular sarcoma.
case_images: The Ki-67 positive index is approximately 10-15%. [(A), xA00]; [(B), HEx400].
case_images: fonc-14-1366554-g004.jpg
case_images: PMC11096474_01_fonc-14-1366554-g004.jpg
case_images: f4
case_images: CD31, CD8, ERG, FLI-1, Vimentin, with a Ki-67 index of 10-15% ( Figure 4 ). Conversely, the tumor tested negative for CD68, D2-40, CD123, CD138, CD56, CD4, CD8, CD20, CD21, CD3, CD30, CD5, and BCL-6.