Thrombocytopenia with multiple splenic lesions - histiocytic sarcoma of the spleen without splenomegaly: A case report

Figure 1 H and E staining and immunohistochemistry. A: H and E staining. Neoplastic cells have abundant eosinophilic and vacuolated cytoplasm, with a large eccentric nucleus and prominent nucleoli (60 × magnification); B: Immunoreactivity for CD163 (20 × magnification); C: Immunoreactivity for CD68 (20 × magnification); D: Immunoreactivity for CD4 (20 × magnification); E: Immunoreactivity for Factor XIII (20 × magnification); F: Ki-67. Proliferation index is approximately 10% (20 × magnification).

Figure 2 Computed tomography. A, B: Spleen shows multiple circumscribed intermediate density lesions of variable size and varying enhancement, with the largest at the hilum measuring 2.4 cm × 2.1 cm and 2.7 cm × 2.1 cm. The differential diagnosis includes lymphoma, splenic peliosis, infection with multiple abscesses, and metastasis.