PMC4247000_01
Computed tomography (CT) images. (A) Pre-contrast CT revealing a large, solitary, well-defined mass in the spleen, with variable areas of necrosis and cystic degeneration. Contrast-enhanced CT revealing the progressively-enhanced cystic wall, internal septa and solid portion during the (B) hepatic arterial, (C) portal venous and (D) hepatic parenchymal phases. The areas of necrosis and cystic degeneration were non-enhancing.
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The mean CT attenuation value of the solid portion was 39 HU, while the values observed for the areas of necrosis and cystic degeneration were 21-23 HU (Fig. 1A). The areas of necrosis and cystic degeneration, however, were non-enhancing (Fig. 1B). During the portal venous and hepatic parenchymal phases, the cystic wall, internal septa and solid portion demonstrated a slight and progressive enhancement, with mean CT attenuation values of 54 HU and 63 HU, respectively (Fig. 1C and D).
Histological features. (A) Immunohistochemistry revealing the invasion of splenic red pulp tissue by pleomorphic tumor cells (hematoxylin and eosin stain; magnification, x40). Inset of A: Tumour tissue composed of plasma cells, with eccentrically situated nuclei and a mild degree of nuclear polymorphism (hematoxylin and eosin stain; magnification, x100). Immunohistochemistry revealing the presence of (B) lambda-light chain-positive and (B) kappa-light chain-negative cells.
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In addition to a variety of binuclear cellular forms with scattered mitoses, perinuclear halos were observed in a number of the cells (Fig. 2A). Furthermore, the immunohistochemical staining was positive for lambda-light chains, but negative for kappa-light chains (Fig. 2B and C).