PMC8437672_01
(a) Coronal CT depicting the ruptured spleen (yellow arrow) with concomitant bleeding in the left upper quadrant. (b) The ruptured spleen (red arrow) in axial CT.
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fig1
He underwent computed tomography (CT) scan which revealed splenic rupture and bleeding located in the left upper quadrant (Figure 1).
(a) Metastatic moderately differentiated adenocarcinoma just below the hemorrhage and neutrophilic infiltrate formed under the splenic capsule tear (H-E x100). (b) Neoplastic glands with dirty necrosis in their lumina, embedded in a desmoplastic stroma with moderate inflammatory infiltration (H-E x200).
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fig2
Microscopically, its morphological characteristics were indicative of metastatic adenocarcinoma moderately and focally poorly differentiated, with necrosis present (Figure 2).
(a) Diffuse and intense cytoplasmic staining of the neoplastic glands with K7 (K7 x200). (b) Diffuse and intense cytoplasmic staining of the neoplastic glands with K19 (K19 x200).
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Immunohistochemical examination results suggested that the primary site was the pancreas or biliary tract (Figure 3).