case_images: PMC7204771_01
case_images: Dynamic computed tomography of the spleen. A gradually enhancing mass (65 x 65 x 55 mm) is observed in the spleen (arrow). No radial visualization of the inside of the tumor is observed. a Simple phase. b Arterial phase. c Portal vein phase. d Equilibrium phase.
case_images: crg-0014-0212-g01.jpg
case_images: PMC7204771_01_crg-0014-0212-g01.jpg
case_images: F1
case_images: Contrast-enhanced abdominal computed tomography (CT) revealed the presence of a gradually enhancing lesion (63 x 56 mm) in the splenic hilum (Fig. 1).
case_images: Laparoscopic and macroscopic findings of spleen. a A swollen tumor is observed at the splenic hilum with no gastric invasion of the tumor. The tumor was grayish in color. b A swollen tumor is observed at the splenic hilum, and there is no tumor exposure. c There is no tumor exposure on the dorsal side of the spleen. d In this section of the spleen, a well-defined grayish tumor is observed.
case_images: crg-0014-0212-g02.jpg
case_images: PMC7204771_01_crg-0014-0212-g02.jpg
case_images: F2
case_images: The patient was administered general anesthesia, positioned in the right semi-lateral position, and 4-port laparoscopy was performed to identify the tumor in the splenic hilum (Fig. 2). The lesion was firm and grayish to whitish tan in color (Fig. 2).
case_images: Histopathology and immunohistochemistry of splenic tumor tissue. a Nodular lesions are covered with thick bundles of collagen fibers. Magnification, x20 . b Multinodular structure of SANT. Magnification, x20. c Infiltration of plasma cells in the thick collagen fibers. Magnification, x200. d The slit-like blood vessels, spindle cells, and circular cells are mixed and shown proliferation in the nodule. Magnification, x100. e Capillary blood vessels positive for CD34 are observed under a microscope. Magnification, x100. f A sinusoid positive for CD8 is observed under a microscope. Magnification, x100. g A vein positive for CD31in fibrotic tissue is observed under a microscope (arrows). Magnification, x100. h CD68-positive cells were accumulated at the center of the lesion. Magnification, x40. i D2-40-positive cells were absent at the center of the lesion. Magnification, x100.
case_images: crg-0014-0212-g03.jpg
case_images: PMC7204771_01_crg-0014-0212-g03.jpg
case_images: F3
case_images: Therefore, the lesion was diagnosed as SANT (Fig. 3).