Systemic lupus erythematosus with multiple calcified fibrous nodules of the spleen.
An autopsy case of systemic lupus erythematosus (SLE) in a 39-year-old woman with peculiar multiple splenic nodules is reported. Multiple calcific nodular shadows were incidentally found in the left hypochondrial region on chest and abdominal X-ray films taken at admission. The patient died of chronic heart failure due to massive pericardial effusion as one of the manifestations of SLE with 2 and a half years' clinical course. Lupus nephritis and terminal miliary tuberculosis were the other conspicuous autopsy findings. The splenic nodules were almost evenly distributed on each cut-surface of the spleen at the density of about 5/cm2. Each nodule was spherical in shape and 1 to 3 mm in diameter. Most of the nodules were calcified in variable degrees. Semi-serial sectionings and reconstruction procedure of the nodules disclosed that they were formed around the central or penicillary arteries and had a close relation to so called "onion-skin lesion" of the spleen in SLE. The true nature, pathogenesis, and relation of the nodules to SLE are discussed.
D000328:Adult; D002114:Calcinosis / Q000209:etiology / Q000473:pathology*; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000473:pathology*; D010490:Pericardial Effusion / Q000209:etiology; D013154:Spleen / Q000473:pathology*; D013158:Splenic Diseases / Q000209:etiology / Q000473:pathology*; D014391:Tuberculosis, Miliary / Q000150:complications