EURORAD ESR

Case 15227

Peritoneal splenosis mimicking peritoneal metastases from invasive ductal carcinoma of the breast (IDC).

Author(s)
Anjali Nandakumar, Helen Bailey, Yajur Narang, Ehab Husain.

Aberdeen Royal Infirmary. Foresterhill, Aberdeen, United Kingdom.
 
Patient
female, 51 year(s)
 
 
  • Figure 1
    Mammography and ultrasound findings
     

    Right Cranio caudal (CC) view. A mass lesion with irregular shape and spiculated margin predominantly in the medial aspect of right breast at 12 to 1 o’clock position.

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Right Medio lateral oblique (MLO) view. A mass lesion with irregular shape and spiculated margin in the upper aspect of right breast, just superior to nipple.

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Ultrasound examination of right breast. An irregular hypoechoic mass with ultrasound features in keeping with malignancy.

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Figure 2.CECT shows peritoneal nodules on staging CT
     

    Left upper quadrant shows peritoneal deposits (arrow)

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Peritoneal splenosis mimicking peritoneal metastases in left upper quadrant(arrows)

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Left upper quadrant peritoneal nodule.(arrow)

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Small and slightly irregular spleen(arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 3
    Slides demonstrating pathological findings
     

    Cores of lymphoid tissue with part of fibrous capsule included.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Higher magnification of one core revealing sinusoidal pattern and aggregates of foamy macrophages at one edge of the core.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Immunohistochemistry with CD45 to identify the lymphoid cells.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Immunohistochemistry using ERG identifies the vascular spaces.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
Right Cranio caudal (CC) view. A mass lesion with irregular shape and spiculated margin predominantly in the medial aspect of right breast at 12 to 1 o’clock position.
 
Right Medio lateral oblique (MLO) view. A mass lesion with irregular shape and spiculated margin in the upper aspect of right breast, just superior to nipple.
 
Ultrasound examination of right breast. An irregular hypoechoic mass with ultrasound features in keeping with malignancy.
 
Left upper quadrant shows peritoneal deposits (arrow)
 
Peritoneal splenosis mimicking peritoneal metastases in left upper quadrant(arrows)
 
Left upper quadrant peritoneal nodule.(arrow)
 
Small and slightly irregular spleen(arrow).
 
Cores of lymphoid tissue with part of fibrous capsule included.
 
Higher magnification of one core revealing sinusoidal pattern and aggregates of foamy macrophages at one edge of the core.
 
Immunohistochemistry with CD45 to identify the lymphoid cells.
 
Immunohistochemistry using ERG identifies the vascular spaces.
 
 
 
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