Spleen برای بزرگنمایی عکسها کلیک را روی ان نگه دارید..... Figure 38.1 Splenogonadal Fusion. Splenic tissue (left) is attached to testicular tissue Figure 38.2 A, Primary (epithelial) cyst. Grossly, it is very difficult, if not impossible, to distinguish this lesion from a pseudocyst. B, Squamous lining of the inner surface Figure 38.3 Primary Splenic Cyst Lined by Mesothelial Cells. A, Gross appearance. B, Immunoreactivity of the lining cells for calretinin Figure 38.4 Primary cysts due to hydatidosis of spleen Figure 38.5 Splenic Secondary Cyst (False or Pseudocyst). A, Outer aspect. B, Inner surface. Notice the white trabeculation Figure 38.6 Gross appearance of a thick-walled splenic abscess. The content is partially purulent and partially hemorrhagic Figure 38.7 Granulomas of spleen due to Mycobacterium avium in an immunosuppressed patient Figure 38.8 Typical gross appearance of perisplenitis ("sugar-coated" or "snow-covered" spleen). (Courtesy of Dr. RA Cooke, Brisbane, Australia. From Cooke RA, Stewart B. Colour Atlas of Anatomical Pathology. Edinburgh: Churchill Livingstone; 2004) Figure 38.9 Gaucher Disease of Spleen. Macrophages with abundant pale acidophilic cytoplasm pack the red pulp Figure 38.10 Passive Congestion of Spleen. The red pulp is massively expanded due to increased content of red blood cells Figure 38.11 Typical wedge-shaped appearance and "anemic" quality of splenic infarct. A second smaller infarct is also present Figure 38.12 Gross Appearances of Various Types of Malignant Lymphoma Involving the Spleen. A, Miliary pattern in small lympho- cytic lymphoma/chronic lymphocytic leukemia. B, Miliary pattern with follicular lymphoma. C and D, Nodular pattern due to involvement by large B-cell lymphoma Figure 38.13 Large B-cell lymphoma of spleen causing diffuse infiltration of the tumor nodule Figure 38.14 Peripheral T-Cell Lymphoma of Spleen Rich in Reactive Histiocytes. A, Low-power appearance. B, CD43 immunoreactivity of neoplastic T cells. C, Lysozyme positivity of reactive histiocytes Figure 38.15 Small lymphocytic lymphoma/chronic lymphocytic leukemia of spleen, replacing normal white pulp with fusion of white pulp nodules and extension of small lymphocytes into the red pulp Figure 38.16 The splenic involvement by small lymphocytic lymphoma/ chronic lymphocytic leukemia results in marked diffuse enlargement of the organ Figure 38.17 Follicular Lymphoma Involving the Spleen. The lower right nodule contains follicular lymphoma, mimicking a germinal center, surrounded by a thin mantle zone. Note the expanded outer marginal zones that may cause confusion with splenic marginal zone lymphoma Figure 38.18 Splenic marginal zone lymphoma showing the classic biphasic pattern of nodules with central small, dark blue-staining lym- phocytes with scant cytoplasm surrounded by an outer zone of cells with more abundant and clear cytoplasm. Small B-lymphocytes also infiltrate the red pulp in aggregates Figure 38.19 Mantle Cell Lymphoma. Note the tiny residual germinal center. The inset shows the monotonous proliferation of centrocyte-like tumor cells Figure 38.20 Hepatosplenic T-Cell Lymphoma. Medium-sized atypical lymphocytes infiltrate the red pulp, surround a white pulp nodule on the left Figure 38.21 A and B, Gross appearance of Hodgkin lymphoma involving the spleen Figure 38.22 Classic Hodgkin lymphoma of spleen. The inset shows typical Reed-Sternberg cells Figure 38.23 Gross Appearance of Hairy Cell Leukemia. Note the diffuse involvement, lack of nodularity, and dark red color Figure 38.24 Splenic Involvement by Hairy Cell Leukemia. The inset shows the bland monotonous appearance of the red pulp infiltrate Figure 38.25 Diffuse involvement of the spleen by primary myelofibrosis Figure 38.26 Abnormal hematopoiesis in splenic red pulp due to involve- ment by primary myelofibrosis, as seen in H&E section (A) and with Leder chloroacetate esterase stain (B) Figure 38.27 Involvement of the Spleen by Systemic Mastocytosis. A, Low-power view showing the perimalpighian and perivascular arrange- ment of the infiltrate. B, High-power view showing clusters of mast cells. C, The mast cells are strongly positive for CD117 and, D, show aberrant expression of CD25 Figure 38.28 Castleman Disease of Hyaline-Vascular Type. A, Splenic involvement. B, Lymph node involvement in the same case Figure 38.29 Diffuse involvement of spleen by benign vascular tumor ("angiomatosis") Figure 38.30 Gross Appearance of Littoral Cell Angioma. Numerous hemorrhagic lesions with a lobular configuration are seen Figure 38.31 Littoral Cell Angioma of Spleen. The vascular spaces are lined by plump cells with the appearance of sinus lining ("littoral") cells Figure 38.32 Littoral cell angioma of spleen showing combined expression of endothelial (A, factor VIII-related antigen) and histiocytic markers (B, lysozyme). The cells lack CD8 (C) a marker expressed by normal splenic sinus lining cells, but show expression of CD21 (D) Figure 38.33 Lymphangioma of Spleen Figure 38.34 Angiosarcoma of Spleen. The tumor is markedly hemorrhagic and necrotic Figure 38.35 Angiosarcoma of Spleen. The tumor cells have markedly hyperchromatic nuclei that protrude into the vascular lumina Figure 38.36 Low-Power Appearance of Splenic Hamartoma. The lesion is formed by disorganized red pulp without white pulp. Residual normal spleen is seen on the right Figure 38.37 Gross Appearance of Sclerosing Angiomatoid NodularTransformation. The bisected spleen shows a firm, stellate, tan-white lesion with foci of hemorrhage Figure 38.38 Sclerosing Angiomatoid Nodular Transformation of Spleen (SANT). A, Low-power appearance showing a distinctly nodular architecture. B, Highly hyalinized area simulating an ancient granuloma. C, Cellular area of clearly angiomatous nature Figure 38.39 Gross appearance of inflammatory pseudotumor-like fibroblastic/follicular dendritic cell sarcoma of the spleen. The cut surface has a variegated color resulting from a combination of necrosis, hemor- rhage, and cellular infiltration Figure 38.40 Inflammatory Pseudotumor-Like Fibroblastic/Follicular Dendritic Cell Sarcoma of Spleen. Spindle cells of myofibroblastic appearance are admixed with various types of inflammatory cell (A). The spindle cells are focally positive for smooth muscle actin (B) and are EBV positive (C) Figure 38.41 Metastatic endometrial carcinoma to the spleen presenting as a single well-circumscribed nodule
