title: Multiple epithelial cysts of the spleen and on the splenic capsule, and high serum levels of CA19-9, CA125 and soluble IL-2 receptor.
abstract: An 18-year-old woman with abdominal pain was diagnosed as having splenic cysts by computed tomography scan. She had high serum levels of CA19-9 (2886.8 U/mL; normal value, <35 U/mL), CA125 (131.1 U/mL; normal value, <35 U/mL) and soluble IL-2 receptor (1490 U/mL; normal range, 220-530 U/mL). The resected spleen weighed 1050 g, was 14 x 28 cm, and had more than 10 macroscopic cysts up to 10.3 x 9.5 cm. There were numerous microscopic cysts in the spleen and several on the splenic capsule. The levels of CA19-9 and CA125 in the cyst fluid were 2165550 U/mL and 160400 U/mL, respectively. After the surgery, the serum levels of the tumor markers decreased gradually. The inside of the largest cyst was mainly covered by granulation tissue with a focal lining of epithelial cells, and the other macroscopic cysts had stratified squamous epithelium. The microscopic splenic cysts and cysts on the splenic capsule were lined by either attenuated single-layered or multilayered epithelial cells. The lining epithelial cells of these cysts were positive for epithelial membrane antigen and cytokeratins. CA19-9 and CA125 were detected in the lining cells of the splenic cysts. In the present case, it is suspected that the splenic cysts were derived from the capsular lining cells that showed migration from the capsule or formed microcysts on the splenic capsule, as in the case of ovarian inclusion cysts.
authors.affiliation: Department of Pathology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugino
authors.forename: Takeaki
authors.initials: T
authors.lastname: Fukuda
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hoshi
authors.forename: Go
authors.initials: G
authors.lastname: Ogura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Satoh
authors.forename: Takeo
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Akio
authors.initials: A
authors.lastname: Ohishi
authors.forename: Jinichi
authors.initials: J
authors.lastname: Haga
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyata
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000293:Adolescent; D018394:CA-125 Antigen / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D003560:Cysts / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015375:Receptors, Interleukin-2 / Q000097:blood*; D013158:Splenic Diseases / Q000097:blood* / Q000473:pathology
chemical_list: D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D015375:Receptors, Interleukin-2