104 Florid Cystic Endosalpingiosis of the Spleen. (11th January 2018)

• Record Type: Journal Article
• Authors: Talwar, Aditya; Mohanty, Alok; Schiffman, Suzanne; Silverman, Jan
• Is Part Of: American journal of clinical pathology. Volume 149(2018)Supplement 1
• Page Start: S45
• Page End: S45
• Publication Date: 2018-01-11
• Subjects: Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqx118.103
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Endosalpingiosis is a condition in which fallopian tube-like epithelium is found outside the fallopian tubes. The etiology is unknown, although it is believed to arise from transformation of the coelomic epithelium and is usually an incidental finding. Endosalpingiosis can be encountered in any location and can sometimes clinically mimic other lesions. We describe a 47-year-old African-American woman who presented with a presumed history of a splenic cyst, which developed approximately two years ago. She underwent multiple drainages, with multiple recurrences. A CT scan in July 2016 revealed a cyst measuring 9.5 x 9 cm, with the radiologic impression of an abscess. A drain was placed; however, she was not treated with antibiotics. A follow-up CT scan showed a 6.5 x 6.3 cm cyst with air fluid level, and she underwent CT-guided drainage. The fluid culture grew alpha hemolytic step, and she was treated for an abscess. In November 2016, she underwent splenectomy, which showed a 7.4 x 4.9 x 4.0 cm multiloculated cyst. Histologically, the cyst demonstrated thick-walled septae and an epithelial lining that showed tubal-type glands with apical snouts. The cyst spaces also showed acidophilic fluid. The epithelium was positive for PAX-8, ER, CAM 5.2 and CK7, consistent with endosalpingiosis. In retrospect, splenic endosalpingiosis clinically mimicked a benign cyst or an abscess, and the positive culture most likely represents contamination in this case. Splenic endosalpingiosis needs to be considered in a cyst diagnosis when a clinically or radiologically suspected cyst or abscess is encountered in the spleen. A review of the literature only showed one other case report ( APMIS, 2006 May; 114(5): 393–8). This is the second case report of florid cystic endosalpingiosis of the spleen.