Epstein-Barr Virus Positive Inflammatory Pseudotumor of the Spleen: Case Report and Review of the Literature

摘要

Inflammatory Pseudotumor (IPT) forms a group of etiologically, histologically, and biologically heterogeneous tumefactive lesions that are histologically characterized by prominent inflammatory infiltrates. It has been described in various organs including the lungs, bladder, liver, spleen, heart, and others. It may mimic a malignant tumor clinically and radiologically. Splenic IPT are most frequently detected incidentally. We report a case of 38-year-old women admitted for recurrent abdominal pain. Physical examination was unremarkable. Contrast enhanced CT showed a well hypodense, circumscribed lesion, measuring 5 × 3.5 cm. A differential diagnosis of lymphoma, teratomas, angioma or angiosarcoma was considered. The patient underwent splenectomy. Histologically, the tumor consisted of an inflammatory infiltrate composed predominantly of diffusely lymphoplasmocytic cells and stromal fibroblasts. Epstein-Barr virus was detected on in situ hybridization exclusively in the epitheloid and spindles cells. The optimal management of this tumor and eventually in asymptomatic patients is still controversial. IPT of the spleen should be remembered when evaluating single or multiple nodules in spleens. The clinical and pathological features of previously reported cases are reviewed in this paper.