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6 Splenogonadal fusion. Splenic tissue is attached to testicular tissue.

7 Pseudocyst (false or secondary cyst). A, Outer aspect.

8 Pseudocyst (false or secondary cyst). B, Inner surface. Notice the white trabeculation.

9 A, Epithelial cyst. Grossly, it is very difficult, if not impossible, to distinguish this lesion from a pseudocyst.

10 B, Squamous lining of the inner surface.

11 Splenic cyst lined by mesothelial cells. A, Gross appearance.

12 Splenic cyst lined by mesothelial cells. B, Immunoreactivity of the lining cells for calretinin.

13 Hydatidosis (nang sán) of spleen.

14 Gross appearance of a thick-walled splenic abscess. The content is partially purulent and partially hemorrhagic.

15 Granulomas of spleen due to M. avium in an immunosuppressed patient.

16 Typical gross appearance of perisplenitis ( sugarcoated or snow-covered spleen).

17 Gaucher s disease of spleen. Macrophages with abundant pale acidophilic cytoplasm pack the red pulp.

18 Passive congestion of spleen. The red pulp is massively expanded due to increased content of red blood cells.

19 Typical wedge-shaped appearance and anemic quality of splenic infarct. A second smaller infarct is also present.

20 Gross appearances of various types of malignant lymphoma involving the spleen. A, Small lymphocytic lymphoma.

21 Gross appearances of various types of malignant lymphoma involving the spleen. B, Follicular lymphoma.

22 Gross appearances of various types of malignant lymphoma involving the spleen. C and D, Large cell lymphoma.

23 Gross appearances of various types of malignant lymphoma involving the spleen. C and D, Large cell lymphoma.

24 Large B-cell lymphoma of spleen causing diffuse infiltration of the organ.

25 Large T-cell lymphoma of spleen rich in reactive histiocytes. A, Low-power appearance.

26 Large T-cell lymphoma of spleen rich in reactive histiocytes. B, CD43 immunoreactivity of neoplastic T cells.

27 Large T-cell lymphoma of spleen rich in reactive histiocytes. C, Lysozyme positivity of reactive histiocytes.

28 Malignant lymphoma of spleen with a nodular pattern of growth, which in this organ is not limited to follicular lymphoma but can be seen in many types of Hodgkin s and non-hodgkin s lymphoma.

29 Small lymphocytic lymphoma of spleen, so-called paraimmunoblastic type.

30 Polypoid growth of malignant lymphoma cells beneath the endothelium of a trabecular vein. This is a useful diagnostic sign.

31 Mantle cell lymphoma. Note the tiny residual germinal center. The inset shows the centrocyte-like appearance of the tumor cells.

32 Hepatosplenic T-cell lymphoma. Highly atypical lymphoid cells are present in a polymorphic background.

33 A and B, Gross appearance of Hodgkin s lymphoma involving the spleen.

34 A and B, Gross appearance of Hodgkin s lymphoma involving the spleen.

35 Classic Hodgkin s lymphoma of spleen, nodular sclerosis subtype. The inset shows typical Reed-Sternberg cells.

36 The splenic involvement by chronic lymphocytic leukemia results in marked diffuse enlargement of the organ.

37 Gross appearance of hairy cell leukemia. Note the diffuse involvement, lack of nodularity, and dark red color.

38 Splenic involvement by hairy cell leukemia. The inset shows the bland monotonous appearance of the infiltrate.

39 Diffuse involvement of the spleen by myelofibrosis.

40 Extramedullary hematopoiesis in spleen, as seen in H&E section (A) and with Leder acetate chloracetate stain (B).

41 Extramedullary hematopoiesis in spleen, as seen in H&E section (A) and with Leder acetate chloracetate stain (B).

42 Involvement of the spleen by systemic mastocytosis. A, Low-power view showing the perimalpighian and perivascular arrangement of the infiltrate.

43 Involvement of the spleen by systemic mastocytosis. B, High-power view showing clusters of mast cells.

44 Castleman s disease of hyaline-vascular type. A, Splenic involvement.

45 Castleman s disease of hyaline-vascular type. B, Lymph node involvement in the same case.

46 Diffuse involvement of spleen by benign vascular tumor ( angiomatosis ).

47 Gross appearance of littoral cell angioma. Numerous hemorrhagic lesions with a lobular configuration are seen.

48 Littoral cell angioma of spleen. The vascular spaces are lined by plump cells with the appearance of sinus lining ( littoral ) cells.

49 Littoral cell angioma of spleen showing combined expression of endothelial and histiocytic markers. A, Factor VIII-related antigen.

50 Littoral cell angioma of spleen showing combined expression of endothelial and histiocytic markers. B, Lysozyme.

51 Multinodular hemangioma of spleen. A, Lowpower appearance showing a distinctly nodular architecture.

52 Multinodular hemangioma of spleen. B, Highly hyalinized area simulating an ancient granuloma.

53 Multinodular hemangioma of spleen. C, Cellular area of clearly angiomatous nature.

54 Lymphangioma of spleen.

55 Angiosarcoma of spleen. The tumor is markedly hemorrhagic and necrotic.

56 Angiosarcoma of spleen. The tumor cells have markedly hyperchromatic nuclei that protrude into the vascular lumina.

57 Low-power appearance of splenic hamartoma. The lesion is formed by disorganized red pulp without malpighian follicles. Residual normal spleen is seen on the right.

58 Gross appearance of inflammatory pseudotumor of the spleen. The cut surface has a variegated color resulting from a combination of necrosis, hemorrhage, and cellular infiltration.

59 Inflammatory pseudotumor of spleen. Spindle cells of myofibroblastic appearance are admixed with various types of inflammatory cells.

60 Metastatic endometrial carcinoma to the spleen presenting as a single well-circumscribed nodule.

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