Histopathological, Histogenetic, and Immunohistochemical Analysis of Epidermoid Cyst of Spleen

Abstract

Splenic cysts are encountered not uncommonly, but large cysts occupying a significant portion of the spleen are extremely rare. We report a case of a young female patient presenting with a large epidermoid cyst involving the majority of the spleen. The patient was involved in a motor vehicle accident during which she sustained multiple rib fractures and traumatic internal organ injuries. She subsequently underwent exploratory laparotomy and splenectomy for grade III splenic lacerations. Incidentally, a 13.3 cm in greatest dimension splenic cyst replacing the majority of the splenic parenchyma was identified. Grossly, the inner lining of cyst was gray-white, smooth, and glistening. Histologically, the thick fibrous cyst wall was composed of stratified squamous epithelium, scattered foci of which were denuded. A panel of properly-controlled immunohistochemical stains was performed and showed the squamous epithelium to be strongly and diffusely immunoreactive with carcinoembryonic antigen (CEA), CA 19–9, and cytokeratin 5/6, focally immunoreactive with HBME-1, and negative for calretinin. The histomorphological features and immunohisto-chemical staining pattern were consistent with a diagnosis of an epidermoid cyst of the spleen.

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S.M. Gilani

S. M. Gilani Department of Pathology St. John Hospital & Medical Center 22101 Moross Road, CCB-SB Detroit, Michigan 48236, USA E-mail: [email protected]