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Epstein-Barr virus-positive inflammatory pseudotumor of the spleen managed with laparoscopic splenectomy
Authors:Norihito Ise  Hideaki Miyazawa  Seiji Satoh  Masatake Iida  Hiroshi Uchinami  Makoto Kume  Masato Yoshioka  Hiroshi Nanjo  Yuzo Yamamoto
Affiliation:(1) Department of Gastroenterological Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan;(2) Department of Clinical Pathology, Akita University School of Medicine, Akita, Japan
Abstract:We report a case of Epstein-Barr virus (EBV)-positive splenic inflammatory pseudotumor treated by laparoscopic splenectomy. A 66-year-old female without symptoms was found to have a solitary, avascular, solid tumor of the spleen by contrast-enhanced computed tomography. The tumor was compatible with a primary tumor of the spleen. A benign splenic tumor was the most likely diagnosis, but malignant lymphoma could not be ruled out because the serum-soluble interleukin-2 receptor (sIL-2R) level was elevated. Laparoscopic splenectomy was performed to enable a definite diagnosis. Removal of the whole spleen without injury was possible. Possible contamination of the extirpation orifice by cancer cells was carefully prevented by enclosing the spleen in a plastic bag. Histopathological examination showed the tumor to be an EBV-positive inflammatory pseudotumor. To the best of our knowledge, this is only the second report of an EBV-positive splenic inflammatory pseudotumor with an increased serum sIL-2R level. Although EBV-positive inflammatory pseudotumors have been reported to recur, no sign of recurrence has been detected in the present case in the 17 months following splenectomy.
Keywords:Inflammatory pseudotumor  Epstein-Barr virus  Laparoscopic splenectomy
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