Humans ; Lymphoma ; Splenic Neoplasms

Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. Although there has been a resurgence of abdominal tuberculosis in immunocompromised patients, which is largely due to the extensive use of immunosuppressive drugs and the increasing incidence of a human immunodeficiency virus infection, splenic tuberculosis is rare, particularly in the immunocompetent patients. Almost all cases of splenic tuberculosis present as multiple hypoechoic foci on sonography or multiple focal hypodense lesions on contrast enhanced computed tomographic scan. To our knowledge, splenic tuberculosis is an extremely rare condition. An 80-year-old man was found to have a large solitary splenic mass mimicking a splenic neoplasm on sonography and contrast enhanced computed tomographic scan. A diagnostic splenectomy revealed a large solitary mass in the spleen, which was consistent with splenic tuberculosis microscopically. We report a rare case of splenic tuberculosis in an elderly man presenting as a large solitary splenic mass on sonography and contrast enhanced computed tomographic scan.
Aged ; Aged, 80 and over ; HIV ; Humans ; Immunocompromised Host ; Incidence ; Spleen ; Splenectomy ; Splenic Neoplasms ; Tuberculosis ; Tuberculosis, Splenic*

Histiocytoma, Benign Fibrous/surgery* ; Humans ; Splenectomy ; Splenic Diseases/pathology* ; Splenic Neoplasms/surgery*

Sclerosing angiomatoid nodular transformation (SANT) is a rare, benign vascular neoplasm. Most patients have no clinical symptoms, and the tumors are usually discovered incidentally on abdominal computed tomography or ultrasonography. Some studies have reported the clinical features and imaging findings of SANT, but the diagnosis is based on histopathologic examination of a tissue specimen obtained at splenectomy. We report herein an incidentally discovered case of SANT and review the related literature.
Diagnosis ; Humans ; Spleen* ; Splenectomy ; Splenic Neoplasms ; Ultrasonography ; Vascular Neoplasms

We developed a novel approach to perform a perfect 11p lymph node dissection (LND), the so-called 'midpancreas mobilization' (MPM) method. Briefly, in pure single-incision laparoscopic distal gastrectomy (SIDG), after the completion of 7, 8a/12a, and 9 LND in the suprapancreatic portion, we started 11p LND after midpancreas mobilization. After mobilization of the entire midpancreas from the white line of Toldt, two gauzes were inserted behind the pancreas. This maneuver facilitated exposure of the splenic vein and complete detachment of soft tissue, including 11p lymph nodes, from the white line of Toldt, which was possible because of the tilting of the pancreas. The dissection plane along the splenic artery and vein for 11p LND could be visualized just through control of the operator's grasper without the need of an assistant. Fourteen patients underwent the procedure without intraoperative events, conversion to conventional laparoscopy, or surgery-related complications, including postoperative pancreatic fistula. All patients underwent D2 LND by exposure of the splenic vein. The mean numbers of retrieved lymph node and 11p lymph node were 61.3 +/- 9.0 (range, 49-70), and 4.00 +/- 3.38 (range, 1-10). Thus, we concluded that MPM for 11p LND in pure SIDG appears feasible and embryologically ideal; this method can be used in conventional laparoscopic gastrectomy.
Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision* ; Lymph Nodes ; Pancreas ; Pancreatic Fistula ; Splenic Artery ; Splenic Vein ; Stomach Neoplasms* ; Veins

Isolated splenic metastasis arising from colorectal carcinoma is very rare and there has been only 6 cases reported in the English literature. A new case is esented, and its possible pathogenesis was considered with previously reported ses. A 65-year-old male patient had received a right hemicolectomy for cending colon cancer 36 months earlier. He was followed up regularly with rial measurement of serum carcinoembryonic antigen (CEA). Rising serum CEA was scovered from 33 months postoperatively and CT revealed an isolated splenic tastasis. He therefore underwent splenectomy, which was proven to be a tastatic adenocarcinoma with similar histological feature to the original mor. As all reported cases showed elevated serum CEA at the time of tastasis, isolated splenic metastasis might be associated with CEA in regard its biological functions of immunosuppression and adhesion.
Adenocarcinoma/surgery ; Adenocarcinoma/secondary* ; Adenocarcinoma/pathology ; Adenocarcinoma/blood ; Aged ; Carcinoembryonic Antigen/blood ; Case Report ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/blood ; Human ; Male ; Splenic Neoplasms/surgery ; Splenic Neoplasms/secondary* ; Splenic Neoplasms/blood ; Tomography Scanners, X-Ray Computed

For resectable gastric cancer, although radical surgery is still the main treatment, methods of operation and the curative effect of operation are still in the stage of exploration for metastatic gastric cancer. Radiotherapy, chemotherapy and molecular targeted therapy also play an important role in prolonging the survival period of patients with gastric cancer. Postoperative radiotherapy and chemotherapy can prolong the survival time, but for patients with locally advanced gastric cancer, the preoperative radiotherapy and chemotherapy can also further improve the survival period of patients compared with direct operation. In addition, with the development and using of molecular targeted drugs, such as antiangiogenic agents, immunosuppressive drugs and so on, the survival period of patients with gastric cancer has been further extended.
Antineoplastic Combined Chemotherapy Protocols ; Gastrectomy ; Humans ; Neoadjuvant Therapy ; Splenic Neoplasms ; Stomach Neoplasms ; drug therapy

Cysts ; diagnosis ; Diagnostic Errors ; Female ; Hemangioma ; diagnosis ; surgery ; Humans ; Laparoscopy ; methods ; Middle Aged ; Splenectomy ; methods ; Splenic Diseases ; diagnosis ; Splenic Neoplasms ; surgery

Splenic pseudocyst is a rare complication of abdominal trauma. Although it is rare, splenic pseudocyst is well-documented in the literature. According to the current classification, approximately 30% of all splenic cysts or pseudocysts result from direct abdominal trauma. In addition, chronic pancreatitis leads to change of nearby organs with possible acute and chronic complications including splenic lesions. This unusual complication can occur in both emergent and nonemergent conditions. The useful diagnostic procedures to assess intrasplenic pseudocyst are sonogram, CT scan, splenic scan, and occasionally angiography. However, definite diagnosis of pseudocyst is possible only after splenectomy when the absence of epithelial lining is confirmed histologically. Splenic pseudocyst requires surgical resection. We experienced a 31-year-old man who confirmed of warmness in the left side of back with left upper quadrant abdominal pain for several months. First impression was splenic lymphangioma based on CT scan and sonogram finding. Splenectomy was performed. Microscopic examination revealed splenic pseudocyst with fibrous capsule without epithelial lining.
Adult ; Cysts/*diagnosis/radiography/ultrasonography ; Diagnosis, Differential ; Humans ; Lymphangioma/diagnosis ; Male ; Splenectomy ; Splenic Diseases/*diagnosis/radiography/ultrasonography ; Splenic Neoplasms/diagnosis ; Tomography, X-Ray Computed

Adult ; Cystadenoma, Serous ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Insulinoma ; surgery ; Male ; Middle Aged ; Pancreas ; injuries ; surgery ; Pancreatic Neoplasms ; surgery ; Splenic Artery ; surgery ; Splenic Vein ; surgery