Epidermoid cyst of spleen mimicking splenic lymphangioma
A 14-year-old boy was admitted with complaint of progressively enlarging mass and pain in left hypochondrium since last few months. There was no history of abdominal trauma and no symptoms like vomiting and constipation pertaining to gastrointestinal tract. History was negative for infection by malaria or any hematological disorder. Physical examination showed good general condition. In the area of left hypochondrium, a smooth firm, non-tender mass was palpable. The liver was not enlarged. The laboratory investigations were within normal limits. On USG, a well-defined intrasplenic hypoechoic lesion was seen measuring 8 cm × 6 cm with internal septations; CT scan also revealed similar findings. Keeping in view the above findings, a clinical diagnosis of lymphangioma was made. Therapeutic procedure in the form of splenectomy was performed due to the large size of the tumor and tissue was sent for histopathologic examination.\nWe received a specimen of spleen measuring 15 cm × 10 cm × 7 cm. On serial sectioning, a large cyst of size 8 cm × 8 cm was identified at one end []. Wall of the cyst showed trabeculations and the cyst contained an opaque dark-colored fluid. Rest of spleen showed congestion. Microsections examined revealed a cyst wall lined by pseudo-stratified epithelium. Focally, the lining epithelium was flattened, and the cyst wall was composed of fibrocollagenous tissue and congested blood vessels. Rest of the splenic tissue showed congestion []. Immunohistochemical panel for epithelial and vascular markers were performed. The lining cells were positive for pancytokeratin and were negative for CD-34 [Figures and ]. The cyst was diagnosed as epithelial cyst rather than lymphangioma.