PMC9618801_01
Ct scan of a mass (arrow) in the left adrenal region. The CT value of plain scanning which the internal density was heterogeneity (A), and enhanced scanning presented moderate enhancement (B), the delayed phase of the mass (C). Coronal image of the mass (D). Sagittal image of the mass (E).
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F1
In order to confirm the diagnosis, computed tomography (CT) scan was conducted, the CT scan confirmed the US findings, showing a 42 x 28 x 36 mm soft-tissue mass shadow in the left adrenal region, and the internal density was heterogeneity (Figures 1A,D,E). The CT value of plain scanning was 36 to 68 HU, and enhanced scanning presented moderate enhancement (Figure 1B). The CT value in the arterial phase was 62 to 104 HU, and that in the delayed phase was 46-89 HU (Figure 1C).
Retroperitoneal laparoscopic resection of the mass (arrow). The mass is located in the left suprarenal region, and the boundaries between the dorsal side of the mass were clear, loose and non-adhered (A), the ventral side adhered closely to the peritoneum (B). Gross appearance. The mass was dark red, and the surface envelope of the mass was intact (C), and had a similar splenic structure with multiple sinusoid tissues (D).
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F2
The boundaries between the dorsal side of the mass and upper pole of the left kidney, left adrenal gland and surrounding adipose tissue were clear, loose and non-adhered (Figure 2A). The mass was completely resected after partial removal of the adhered peritoneum and blocking of blood vessels (Figure 2B). The anatomopathological exam revealed a 40 x 30 mm in size, which the surface envelope was intact, and the mass was dark red and had a similar splenic structure with multiple sinusoid tissues (Figures 2C,D).
Microscopic appearance (A,B). Histologic magnification revealed accessory splenic tissue [hematoxilyn and eosin staining, x200 (A), x400 (B)].
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F3
In the histological examination, the splenic corpuscle and splenic medullary structure were seen under the microscope, and an accessory spleen was diagnosed (Figures 3A,B).