title: [Clinicopathologic features and diagnosis of metastatic carcinoma to the spleen].
abstract: OBJECTIVE
  To study the clinicopathologic features and diagnosis of metastatic carcinoma to the spleen (MCS).
  
  
  METHODS
  Four patients (1 man and 3 women, mean age 43.5 years) with MCS were analyzed clinicopathologically.
  
  
  RESULTS
  The four MCS patients accounted for 1.3% of 308 patients having spleen biopsy from 1959 to 1999. Their chief presentations were pain and mass in the left upper quadrant of the abdomen. The mass was located in the upper pole of the spleen (1 patient), the lower pole of the spleen (2), or the lower pole and hilum of the spleen (1). Macroscopically, all of the lesions were nodular. Histologic type of these MCSs included acinar cell carcinoma of the pancreas (2 patients), transverse colon adenocarcinoma (1), and hepatic cell carcinoma (1). Clinically, 1 patient was diagnosed as having MCS and 3 were misdiagnosed. According to Chinese literature, the clinicopathologic features of MCS were as follows: (1) 66.7% of the patients with MCS were aged 30 approximately 60 years, with a mean of 51.2 years. (2) 76.3% of the patients presented with pain in the left upper quadrant of the abdomen and 63.2% with splenomegaly and splenic masses. (3) Macroscopically, nodular lesions accounted for 68.4%. (4) Microscopically, 84.2% of the lesions were adenocarcinomas and 70.3% originated from carcinomas of the colon, liver, ovary and pancreas. (5) B-mode ultrasonography and/or CT showed occupying lesions or masses in the spleen in 76.7%, and MCS in 11.8%. (6) Clinically, 73.7% of the patients were misdiagnosed.
  
  
  CONCLUSIONS
  MCS is uncommon but its clinical misdiagnosis rate is high. Image examination is of value in clinical diagnosis. Cooperation of clinicians and pathologists may enhance the diagnostic level of MCS.
authors.affiliation: Department of Pathology, Medical College of Three Gorges University, Yichang 443003, China.
authors.forename: Zhaoxiang
authors.initials: Z
authors.lastname: Zhang
authors.forename: Zhong
authors.initials: Z
authors.lastname: Fang
authors.forename: Junping
authors.initials: J
authors.lastname: Ye
authors.forename: Caiyun
authors.initials: C
authors.lastname: Tao
authors.forename: Muhua
authors.initials: M
authors.lastname: Yi
authors.forename: Hua
authors.initials: H
authors.lastname: Lu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013160:Splenic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary*