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JAMA Surgery Clinical Challenge |

Calcified Cyst in the Spleen QUIZ

Run-De Jiang, MD1; Zong-Li Zhang, MD1; Tao Li, MD1
[+] Author Affiliations
1Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China
JAMA Surg. 2016;151(7):675-676. doi:10.1001/jamasurg.2016.0060.
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A man in his mid-50s was referred to our hospital because he had a cystic mass in his spleen that was discovered incidentally during a routine physical examination. He had no history of abdominal trauma, infection, or surgery. What is your diagnosis?

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Figure 1.

A, Computed tomography (CT) revealed a large, well-defined, cystic mass with mural calcification in the spleen. B, The surface of the cyst was extremely dense and appeared to have an eggshell-like calcification; the cyst was filled with about 300 mL of yellowish opalescent fluid containing numerous cholesterol-like crystals (arrowhead).

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Figure 2.

Histologic examination showed that the cyst wall consisted of fibrous tissue with no evidence of an epithelial lining, and calcification (arrowhead) was found in the fibrotic wall (original magnification ×100).

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