0
February 2010, Vol 145, No. 2 >
Special Feature | February 2010

Image of the Month—Quiz Case FREE

Shankar R. Raman, MD, MRCS; Vellore S. Parithivel, MD; Masooma Niazi, MD
[+] Author Affiliations

Section Editor: Carl E. Bredenberg, MD

More Author Information
Arch Surg. 2010;145(2):205. doi:10.1001/archsurg.2009.279-a.
Text Size: A A A
Published online
Article
Figures
Comments
Figures in this Article

A 50-year old-man presented to the clinic with pain in the left upper quadrant of the abdomen of approximately 4 months’ duration. His medical history included hypertension that was well controlled by medication. The patient denied any other symptoms. On physical examination there were no pertinent findings, specifically, no splenomegaly, hepatomegaly, or lymphadenopathy. Laboratory data were also within the reference limits.

A computed tomographic scan showed a 5.5 × 4.5-cm solid area in the spleen (Figure 1) that had grown in size over 3 months. The spleen showed decreased attenuation in the arterial phase. The lesion remained persistently photopenic on nuclear imaging. Despite intensive evaluation, the nature of the splenic neoplasm was not clear. As the patient was symptomatic and the lesion was increasing in size, the patient was scheduled for laparoscopic splenectomy after preoperative immunization.

Place holder to copy figure label and caption
Figure 1

Splenic lesion on a computed tomographic scan.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

The patient had a successful laparoscopic splenectomy with intact removal of the spleen. The lesion is shown in Figure 2.

Place holder to copy figure label and caption
Figure 2

Cut surface of the spleen showing a bosselated mass with multiple dark brown nodules interspersed with stellate whitish fibrotic stroma.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

WHAT IS THE DIAGNOSIS?

A. Epithelioid hemangioendothelioma

B. Metastasis

C. Sclerosing angiomatoid nodular transformation

D. Kaposi sarcoma

Answer

Figures

Place holder to copy figure label and caption
Figure 1

Splenic lesion on a computed tomographic scan.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.
Place holder to copy figure label and caption
Figure 2

Cut surface of the spleen showing a bosselated mass with multiple dark brown nodules interspersed with stellate whitish fibrotic stroma.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Special Feature
Image of the Month—Diagnosis
Arch Surg. 2010;145(2):206. doi:10.1001/archsurg.2009.279-b.
Articles Related By Topic
Related Topics
© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems