case_images: PMC9483013_01
case_images: The patient's splenic CT scan. (A) Plain CT scan showed that the spleen was a round mass shadow in the parenchyma, with punctate calcifications (white arrows). The normal parenchyma was poorly demarcated. (B,C) Contrast-enhanced CT showed that the tumor enhancement was weaker than that of the normal spleen, with clear borders, and a strip-like cleft-like non-enhanced area (white arrow). (D) B-ultrasound showed a heterogeneous low echo in the spleen, with a spot-like strong echo (white arrow). CT, Computed Tomography.
case_images: fsurg-09-973106-g001.jpg
case_images: PMC9483013_01_fsurg-09-973106-g001.jpg
case_images: F1
case_images: The ultrasonographic findings were as follows: Inhomogeneous hypoechoic mass with calcification in the spleen, hemangioma requiring excision, and further examination was recommended (Figure 1D). Plain and contrast-enhanced CT scans of the spleen showed local enlargement of the spleen, with a type of circular isodensity and punctate calcifications (Figure 1).
case_images: MRI of the patient's spleen. (A) Conventional spleen MRI scan showed a type of round mass in the spleen (white arrows). Most of the lesions on T1WI showed isointensity shadows, and localized slightly high signal shadows. (B) Most of the lesions on T2WI showed slightly low signal shadows, with strip-shaped high and low mixed signal shadows (white arrows). (C) In the DWI sequence, the overall signal was low, and lower signal shadow was seen inside (white arrow). (D-F) Contrast-enhanced MRI showed obvious enhancement in the arterial and venous phases of the lesion, with strip-like unenhanced and enhanced areas inside (white arrows) in delayed scan, and isointensity shadows in the remaining areas. DWI, diffusion-weighted imaging; MRI, magnetic resonance imaging; T1WI, T1-weighted imaging; T2WI, T2-weighted imaging.
case_images: fsurg-09-973106-g002.jpg
case_images: PMC9483013_01_fsurg-09-973106-g002.jpg
case_images: F2
case_images: CT value of about 40 HU on the plain scan, and a CT value of about 84 HU in the enhanced part of the venous phase. Conventional and contrast-enhanced magnetic resonance imaging (MRI) scans of the spleen showed localized enlargement of the spleen with abnormal intracellular signal and well-defined lesions (Figure 2).
case_images: (A) The tumor cells were arranged in bundles and spirals, and the cells were oval. No mitoses were seen. There were scattered lymphocytes and plasma cells infiltrating HE-200. (B) Fibrous capsule (white arrow) HE-100 was visible at the tumor margin. (C) The tumor showed poorly defined borders and no capsule (white arrow) HE-100. (D) Intratumoral scar tissue (white arrow). (E) Thick blood vessels (white arrows) HE-100 were seen in the scar. (F) Tumor cells were positive for CD21 HE-21. (G) Tumor cells were positive for CD23 HE-100. (H) Tumor cells expressed 20%-30% Ki-67 HE-100. (I) Positive EBER expression was seen in tumor cells for HE-200.
case_images: fsurg-09-973106-g003.jpg
case_images: PMC9483013_01_fsurg-09-973106-g003.jpg
case_images: F3
case_images: In situ hybridization showed EBER positive (Figure 3).