case_images: PMC11157051_01
case_images: The 67-year-old male patient with primary splenic angiosarcoma. (A) Non-contrast-enhanced CT, (B) enhanced CT-arterial phase, (C) enhanced CT-venous phase, and (D) enhanced CT-delayed phase. The non-contrast-enhanced CT scan of the abdomen revealed a spleen that was significantly enlarged in volume, with an irregular shape and the presence of multiple nodules and clumpy low-density shadows. The boundaries of these lesions were unclear, and the density throughout the spleen was uneven, indicating multiple areas of necrosis [arrow, (A)]. In the enhanced CT images, there was diffuse, uneven mild enhancement of the spleen, with the enhancement becoming more pronounced over time [arrows, (D)]. Additionally, the scan identified multiple nodular low-density shadows in the liver [arrows, (B)], which showed slight enhancement upon closer examination.
case_images: fonc-14-1366560-g001.jpg
case_images: PMC11157051_01_fonc-14-1366560-g001.jpg
case_images: f1
case_images: The non-contrast-enhanced CT scan of the abdomen ( Figure 1 ) revealed a significantly enlarged spleen with an irregular shape, multiple nodules, and clumpy low-density shadows. The enhanced CT scan ( Figure 1 ) showed diffuse, uneven mild enhancement of the spleen, with the degree of enhancement increasing over time.
case_images: The 67-year-old male patient with primary splenic angiosarcoma. (A) Whole body MIP, (B) axial CT, (C) axial fusion, (D) coronal CT, (E) coronal fusion, (F) sagittal CT, and (G) sagittal fusion. The CT scan revealed multiple nodular and massive lesions within the spleen [arrows, (B)], accompanied by numerous necrotic areas [arrows, (D, F)]. 18F-FDG PET/CT imaging demonstrated an abnormal and uneven uptake of 18F-FDG throughout the spleen, with a maximum standardized uptake value (SUVmax) of 9.0 [black arrows, (C)], and no FDG uptake was observed in some of the necrotic regions [black arrows, (E, G)]. Additionally, there were multiple nodular lesions in the liver with elevated FDG metabolism, registering an SUVmax of 5.6 [red arrows, (C)]. A focal area of increased FDG uptake in the thorax was considered to be non-specific mediastinal lymph node activity [blue arrow, (A)].
case_images: fonc-14-1366560-g002.jpg
case_images: PMC11157051_01_fonc-14-1366560-g002.jpg
case_images: f2
case_images: Multiple nodular low-density shadows were also observed in the liver, which showed slight enhancement on the enhanced scan. 18F-FDG PET/CT ( Figure 2 ) revealed multiple nodular and massive lesions in the spleen with multiple necrotic areas.
case_images: The 67-year-old male patient with primary splenic angiosarcoma. (A) H&E x40, (B) H&E x100, (C) H&E x200, and (D) H&E x400. The tumor cells were round, oval, or fusiform, with obvious atypia, arranged into a cable or anastomosed vascular lumen.
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case_images: PMC11157051_01_fonc-14-1366560-g003.jpg
case_images: f3
case_images: Pathological examination ( Figure 3 ) revealed tumor cells that were round, oval, or fusiform with marked atypia, arranged in a cable-like pattern or forming vascular lumens.