Two Cases of Inflammatory Pseudotumor of The Spleen

Kunihiro Kawashima, Eishi Onuma, Toshimitsu Majima, Sueharu Iwamoto, Masatoshi Kimoto, Yasuhisa Yamamoto and Tsukasa Tsunoda

Department of Gastroenterological Surgery, Kawasaki Medical School

Two cases of inflammatory pseudotumor of the spleen are reported. In the first case, a splenic mass was incidentally detected by abdominal ultrasonography in a 53-year-old man during follow up of the postoperative course of distal gastrectomy for gastric cancer. An abdominal CT scan revealed a well-encapsulated splenic mass, and only the capsule was enhanced. Solitary splenic metastasis of the gastric cancer and splenic hamartoma were considered in the differential diagnosis, and splenectomy was performed. In the second case, a 40-year-old woman who had undergone total hysterectomy six years before was also incidentally found to have a splenic mass by abdominal ultrasonography during observation of a gastric submucosal tumor. An abdominal CT scan revealed an isodensity mass in the spleen, and MRI showed a low intensity mass. The interior of the mass was slightly enhanced after Ga-DPTA administration. Based on our experience in the first case, we diagnosed the mass as an inflammatory pseudotumor of the spleen and performed splenectomy. Both tumors were histologically diagnosed as inflammatory pseudotumor of the spleen. Laparotomy had been performed previously in both cases, and this operative procedure appeared to be associated with the pathogenesis of the inflammatory pseudotumors.

Key words
inflammatory pseudotumor, splenic tumor

Reprint requests
Kunihiro Kawashima Department of Surgery, Sumitomo Besshi Hospital 3-1 Ohji-cho, Niihama, 792-8543 JAPAN

Accepted
November 30, 1999

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