PMC3980515_01
Axial CT image showing splenic mass.
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A routine follow-up CT scan of the abdomen demonstrated a 7.2 cm x 7.4 cm mixed attenuation, solid rim-enhancing mass lesion in the hilum of the spleen (Figs. 1 and 2). At the time of her CT scan she was virtually asymptomatic with the exception of some 'fullness in the upper abdomen'.
Coronal CT image of splenic mass.
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A routine follow-up CT scan of the abdomen demonstrated a 7.2 cm x 7.4 cm mixed attenuation, solid rim-enhancing mass lesion in the hilum of the spleen (Figs. 1 and 2). At the time of her CT scan she was virtually asymptomatic with the exception of some 'fullness in the upper abdomen'.
A section through the spleen shows a well circumscribed, firm, white tumour mass measuring 8 cm in diameter.
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October 2011. On sectioning the normal sized spleen there was a rubbery, well-defined tumour measuring 8 cm x 6.5 cm x 5 cm (Fig. 3).
Haematoxylin and eosin stain (original magnification 200x) showing rather spindled cells a background of lymphocytes, plasma cells and scattered eosinophils.
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Histology showed a tumour composed of spindle cells, intimately admixed with lymphocytes, plasma cells and occasional eosinophils (Fig. 4).
EBER in situ hybridisation showing Epstein-Barr virus encoded RNA, predominantly in the spindle cells, with no staining in the smaller lymphocytes (original magnification 400x).
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In situ hybridisation for Epstein-Barr virus revealed Epstein-Barr virus encoded RNA (EBER) in all of the spindle tumour cells (Fig. 5).