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Presented by Pedram Argani, M.D. and prepared by Lynette S. Nichols, M.D.
Case 6: The patient is a 15-year old male, status post trauma to the spleen.
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1. Question
Week 135: Case 6
The patient is a 15-year old male, status post trauma to the spleen.images/Lyn’s/1p-6a.jpg
images/Lyn’s/1p-6b.jpg
images/Lyn’s/1p-6c.jpgCorrect
Answer: True epithelial cyst and false cyst
Histology: The spleen is associated with an organizing hematoma, which results in the commonly-seen false cyst of the spleen after trauma. However, there are foci with a well-defined epithelial lining, which is predominantly squamous but focally demonstrates mucous cells. These are the typical findings of true epithelial cysts of the spleen.
Discussion: Among nonparasitic cysts, the vast majority of splenic cysts are false, meaning that they lack a true epithelial lining. True epithelial cysts typically occur in children and young adults. These types of cysts cannot be distinguished on gross examination, as both demonstrate prominent trabeculation to their inner surface. The absence of mesenchymal elements in addition to the epithelial lining helps to exclude the possibility of a teratoma.
Incorrect
Answer: True epithelial cyst and false cyst
Histology: The spleen is associated with an organizing hematoma, which results in the commonly-seen false cyst of the spleen after trauma. However, there are foci with a well-defined epithelial lining, which is predominantly squamous but focally demonstrates mucous cells. These are the typical findings of true epithelial cysts of the spleen.
Discussion: Among nonparasitic cysts, the vast majority of splenic cysts are false, meaning that they lack a true epithelial lining. True epithelial cysts typically occur in children and young adults. These types of cysts cannot be distinguished on gross examination, as both demonstrate prominent trabeculation to their inner surface. The absence of mesenchymal elements in addition to the epithelial lining helps to exclude the possibility of a teratoma.