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Presented by Ralph Hruban, M.D. and prepared by ChanJuan Shi, M.D., Ph.D.
Case 2: This elderly male was in a motorcycle accident.
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Question 1 of 1
1. Question
Week 370: Case 2
This elderly male was in a motorcycle accident. His flank was injured and a CT scan was performed revealing a well-defined mass in the tail of his pancreas. The mass enhanced during the arterial phase.images/RHH102708-2.jpg
images/RHH102708-2E.jpgCorrect
Answer: Heterotopic spleen
Histology: The gross image shows a well-demarcated red mass within the pancreatic parenchyma. By light microscopy the mass is composed of splenic parenchyma.
Discussion: The differential diagnosis for lesions with this gross appearance would include heterotopic spleen, a well-differentiated endocrine neoplasm, and the solid-pseudopapillary neoplasm. Well-differentiated endocrine neoplasms are usually tan-white, although some can be very vascular. Definitive diagnosis usually requires histology. Most cases of heterotopic spleen are present in the tail of the gland. In very rare cases one can even get an epithelial cyst within the heterotopic spleen.
Incorrect
Answer: Heterotopic spleen
Histology: The gross image shows a well-demarcated red mass within the pancreatic parenchyma. By light microscopy the mass is composed of splenic parenchyma.
Discussion: The differential diagnosis for lesions with this gross appearance would include heterotopic spleen, a well-differentiated endocrine neoplasm, and the solid-pseudopapillary neoplasm. Well-differentiated endocrine neoplasms are usually tan-white, although some can be very vascular. Definitive diagnosis usually requires histology. Most cases of heterotopic spleen are present in the tail of the gland. In very rare cases one can even get an epithelial cyst within the heterotopic spleen.
