PMC6886353_01
Coronal plane CT image of large intra-abdominal wandering spleen with cystic masses.
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Subsequent CT imaging exhibited an enlarged, wandering spleen measuring 24.5 x 16.0 x 12.0 cm, in the patient's left lower abdomen and extending into the anterior mid pelvis (Figure 1).
Stratified squamous epithelial lined splenic cyst (epidermoid cyst) (H&E 100 magnification; 10x).
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Histology showed a variable stratified squamous cell epithelium and simple cuboidal to flat mesothelial cell lining on densely fibrotic walls of variably sized cystic spaces. (Figure 2) Immunohistochemistry was positive for CK5/6 and CEA in the squamous lining of the cystic spaces, confirming a splenic epidermoid cyst. (Figures 3(a)-3(c)) The mesothelial cells were also CK5/6 but were also calretinin positive.
(a) Splenic epidermoid cyst with stratified squamous epithelial with focal mucous cells and simple flat mesothelial cell cyst lining (H&E 100 magnification; 10x). (b) CK5/6 IHC marking both stratified squamous epithelial and simple flat mesothelial cell lining cells (100 magnification; 10x). (c) CEA IHC marking stratified squamous epithelial cells (200 magnification; 20x).
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Histology showed a variable stratified squamous cell epithelium and simple cuboidal to flat mesothelial cell lining on densely fibrotic walls of variably sized cystic spaces. (Figure 2) Immunohistochemistry was positive for CK5/6 and CEA in the squamous lining of the cystic spaces, confirming a splenic epidermoid cyst. (Figures 3(a)-3(c)) The mesothelial cells were also CK5/6 but were also calretinin positive.
Mucicarmine marking mucin collection in the midst of stratified squamous epithelium in a splenic epidermoid cyst (600 magnification; 60x).
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Mucicarmine focally marked mucous cells within the squamous epithelial lining. (Figure 4) No skin adnexa or other mesodermal or endodermal structures were seen, helping to exclude a dermoid cyst or cystic teratoma.