PMC7204771_01
Dynamic computed tomography of the spleen. A gradually enhancing mass (65 x 65 x 55 mm) is observed in the spleen (arrow). No radial visualization of the inside of the tumor is observed. a Simple phase. b Arterial phase. c Portal vein phase. d Equilibrium phase.
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F1
Contrast-enhanced abdominal computed tomography (CT) revealed the presence of a gradually enhancing lesion (63 x 56 mm) in the splenic hilum (Fig. 1).
Laparoscopic and macroscopic findings of spleen. a A swollen tumor is observed at the splenic hilum with no gastric invasion of the tumor. The tumor was grayish in color. b A swollen tumor is observed at the splenic hilum, and there is no tumor exposure. c There is no tumor exposure on the dorsal side of the spleen. d In this section of the spleen, a well-defined grayish tumor is observed.
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F2
The patient was administered general anesthesia, positioned in the right semi-lateral position, and 4-port laparoscopy was performed to identify the tumor in the splenic hilum (Fig. 2). The lesion was firm and grayish to whitish tan in color (Fig. 2).
Histopathology and immunohistochemistry of splenic tumor tissue. a Nodular lesions are covered with thick bundles of collagen fibers. Magnification, x20 . b Multinodular structure of SANT. Magnification, x20. c Infiltration of plasma cells in the thick collagen fibers. Magnification, x200. d The slit-like blood vessels, spindle cells, and circular cells are mixed and shown proliferation in the nodule. Magnification, x100. e Capillary blood vessels positive for CD34 are observed under a microscope. Magnification, x100. f A sinusoid positive for CD8 is observed under a microscope. Magnification, x100. g A vein positive for CD31in fibrotic tissue is observed under a microscope (arrows). Magnification, x100. h CD68-positive cells were accumulated at the center of the lesion. Magnification, x40. i D2-40-positive cells were absent at the center of the lesion. Magnification, x100.
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F3
Therefore, the lesion was diagnosed as SANT (Fig. 3).