A Case of Inflammatory Pseudotumor of the Spleen with Epstein-Barr Virus Infection Complicated by Immune Thrombocytopenic Purpura

Shinichiro Kobayashi, Ryutaro Sakabe, Naoki Hirabayashi, Yukio Sato, Shuji Saeki, Hidenori Mukaida, Yoshinori Yamashita, Wataru Takiyama and Mayumi Kaneko*

Department of Surgery and Department of Pathology*, Hiroshima City Asa Hospital

We report a patient with an inflammatory pseudotumor (IPT) of the spleen with Epstein-Barr virus (EBV) infection complicated by immune thrombocytopenic purpura. A 67-year-old man found in several ultrasound examinations, computed tomography (CT), and magnetic resonance image (MRI) during treatment for immune thrombocytopenic purpura to have a splenic tumor. He had been observed for six months under the diagnosis of a possibly benign neoplasm such as hemangioma, but the tumor grew and was identified by fluorine-18-fluorodeoxyglucose and positron emission tomography to be potentially malignant, necessitating laparoscopic splenectomy. Histopathologic examination showed an inflammatory pseudotumor with spindle cells positive for EBV by in situ hybridization. No recurrence of thrombocytopenia or other IPT was noted after splenectomy. This suggests that EBV infection may play a role in IPT of the spleen and the development of thrombocytopenic purpura.

Key words
inflammatory pseudotumor, spleen, immune thrombocytopenic purpura

Reprint requests
Shinichiro Kobayashi Department of Surgery, Hiroshima City Asa Hospital
2-1-1 Kabeminami, Asa kita-ku, Hiroshima, 731-0223 JAPAN

Accepted
May 21, 2008

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