Splenectomy and Partial Gasterctomy: Diffuse Large Cell B-Cell Lymphoma
The specimen is received fresh labeled “spleen and portion of stomach” and consists of a splenectomy and partial gastrectomy specimen weighing 1120 g in total. The gastric margin of resection is stapled and once removed the underlying new margin is inked in blue. The stomach measures 3.0 cm in length and 5.0 cm in diameter with an attached segment of omental fat measuring 19.0 cm. The markedly enlarged spleen measures 15.0 x 14.0 x 10.5 cm and is covered by a tan-brown focally mottled capsule and fragmented fatty soft tissue.
Sectioning through the spleen reveals a 13.0 x 13.0 x 8.0 cm mass occupying approximately 85% of the entire spleen. The mass is centrally and markedly necrotic, focally calcified, focally hemorrhagic, and surrounded by multifocal areas of tan-white, fleshy, glistening soft tissue. There are no discernable borders to the mass. The mass comes to within 0.1 cm of this splenic capsule, within 0.1 cm of the muscularis of the stomach, but does not appear to grossly invade into the mucosa, and is well removed from the stomach margin of resection. The mucosa of the stomach exhibits normal rugal folds and is ringed by hemorrhage in the area where the mass approaches the mucosa. The remainder of the spleen parenchyma is red-brown, spongy, and unremarkable. A portion of the splenic mass is sent for flow cytometry.
Representative sections are submitted in cassettes A1-A15 as follows:
- A1-A3: Stomach margin of resection (inked in blue)
- A4-A10: Splenic mass, including fleshy areas, and relationship to splenic capsule (inked in orange)
- A 11-A13: Splenic mass in relation to stomach
- A 14-A15: Uninvolved spleen
ALINA MAYSTERCHUK 