A Case of Splenic Inflammatory Pseudotumor with Radial Hypodese Zone on T2-weighted MRI in the Spleen -Review of the Japanese Literature-

Hiroshi Yoshioka, Kazuo Kurayoshi, Kikuhiro Kouno, Hirotomo Kanayama and Jun Inoue

First Department of Surgery, Matsue City Hospital

We report a case of inflammatory pseudotumor (IPT) with radial hypodese zone on T2-weighted MRI in the spleen. A 51-year-old man admitted for medical examination of a heterogenous hypoechoic tumor with an unclear margin in the spleen found by abdominal echography had no complaints and his blood date was all within normal limits. CEA and CA19-9 were within normal ranges. CT showed heterogeneous hypointense area with delayed contrast enhancement. On T1-weighted MRI, the tumor showed heterogeneous hypointensity. After administration of Gd-DTPA, the delayed phased image showed tumor enhancement. Especially, T2-weighted MRI showed radial hypodese zone in our case. We conducted splenectomy under a diagnosis of primary splenic tumor. The spleen weighed 116 g and the mass measured 3.5×3.5×2.5 cm. Histopathollogicaly, the tumor was diagnosed as splenic IPT. The radial hypodense zone on the T2-weighted MRI corersponded to a large amount of fibrous tisse. Preoperatively it is important but difficult to distinguish a benign splenic IPT from malignant tumors. We review 64 cases including ours in the Japanese literature clinically and radiographically

Key words
inflammatory pseudotumor, spleen

Reprint requests
Hiroshi Yoshioka First Department of Surgery, Matsue City Hospital
101 Nadamachi, Matsue, 690-8509 JAPAN

Accepted
September 24, 2003

To read the PDF file you will need Abobe Reader installed on your computer.