Abstract
A 63 year old man with type B chronic hepatitis, underwent partial hepatectomy for hepatocellular carcinoma (HCC) in Couinaud’s segment 5. After following up for 10 months, abdominal CT scan demonstrated some hypovascular tumors in the spleen. These tumors showed abnormal accumulation on FDG-PET examination. Both of metastatic splenic tumor of HCC and primary splenic lymphoma were considered as differential diagnosis. Laparoscopic splenectomy was performed for the purpose of diagnosis and treatment. The attachment around the spleen was dissected with Laparoscopic coagulating shears, and the splenic hilum was stapled with automatic suture device. He was discharged eitht days after surgery. Macroscopic findings showed multiple whitish tumors in the spleen. Pathological findings showed expansion of marginal zone area at the white pulp, with proliferation of atypical lymphoid cells. Immunohistochemical staining showed CD20 and bcl-2 positive cells, whith was diagnostic of splenic marginal zone lymphoma. Diagnosis of splenic tumors is often difficult before surgical resection. Less-invasive laparoscopic splenectomy may be a useful choice for diagnosis and treatment for sunknown splenic tumors.
