case_images: PMC3033349_01
case_images: Computed tomography (CT) scan. The CT scan demonstrates hemoperitoneum and a grade IV splenic laceration in our patient, who had no history of trauma.
case_images: 1752-1947-5-29-1.jpg
case_images: PMC3033349_01_1752-1947-5-29-1.jpg
case_images: F1
case_images: A computed tomography (CT) scan of the abdomen and pelvis revealed an enlarged and fractured spleen with surrounding hematoma, but no evidence of liver laceration, infarct or intra-abdominal abscess (Figure 1).
case_images: Initial view of the gross spleen. The enlarged and fractured spleen as seen through a left subcostal incision.
case_images: 1752-1947-5-29-2.jpg
case_images: PMC3033349_01_1752-1947-5-29-2.jpg
case_images: F2
case_images: A subcostal incision revealed approximately 2L of blood inside the abdominal cavity, an enlarged spleen with grade IV disruption (Figure 2), and an aneurysmal splenic artery.
case_images: Gross spleen. The grossly enlarged spleen cut along the short axis with no evidence of abscess formation.
case_images: 1752-1947-5-29-3.jpg
case_images: PMC3033349_01_1752-1947-5-29-3.jpg
case_images: F3
case_images: When the gross spleen was sectioned along its short axis in the operating room (Figure 3) no abscess was found.
case_images: Hematoxylin and eosin staining results. Hematoxylin and eosin stain of splenic tissue at 40 x magnification showing amyloid around a blood vessel (arrow).
case_images: 1752-1947-5-29-4.jpg
case_images: PMC3033349_01_1752-1947-5-29-4.jpg
case_images: F4
case_images: Staining for amyloid was strikingly positive (Figure 4).
case_images: Peri-vascular amyloid. Positive peri-vascular amyloid A immunoperoxidase staining at 40 x magnification.
case_images: 1752-1947-5-29-5.jpg
case_images: PMC3033349_01_1752-1947-5-29-5.jpg
case_images: F5
case_images: Characteristic talc crystals were observed inside the splenic parenchyma (Figure 5).