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Baço ­ acessório localizado dentro do parênquima pancreático ­ é uma anomalia congênita do tecido esplênico, com características morfológicas e histológicas semelhantes ao baço normal apresentado, geralmente, na cauda do pâncreas. O baço acessório intrapancreático (BAI) trata-se, sobretudo, de uma lesão benigna, usualmente assintomática e encontrada incidentalmente em estudos de imagem, mas que suscitam frequentemente uma preocupação de malignidade e podem ser radiologicamente indistinguíveis de tumores neuroendócrinos, tumores pancreáticos e adenocarcinomas. O presente estudo visa, portanto, relatar um caso de baço acessório intrapancreático através da tomografia computadorizada (TC) e ressonância magnética (RM), além de correlacionar os achados radiográficos do relato de caso com outros métodos radiológicos encontrados na revisão de literatura. As informações contidas foram obtidas por meio de revisão do prontuário, entrevista com o paciente, registro fotográfico dos métodos diagnósticos em geral e dados laboratoriais, aos quais o paciente foi submetido. Nesse contexto, o relato de caso é de um homem com história prévia de carcinoma de células renais que, após realização de nefrectomia total à esquerda e de linfonodos retroperitoneais, constatou no seguimento de seus exames de controle pós-operatório uma imagem nodular na cauda pancreática sugestiva de metástase, mas que, através do estudo tomográfico e de RM, foi possível realizar o correto diagnóstico, tratando-se apenas de uma afecção benigna assintomática e de intervenção conservadora descrita como BAI (AU).

The spleen, an accessory organ located within the pancreatic parenchyma, is a congenital anomaly of the splenic tissue with morphological and histological characteristics resembling a normal spleen, usually in the tail of the pancreas. The intra-pancreatic accessory spleen (IPAS) is mainly a benign lesion, being usually asymptomatic and found on imaging studies on an incidental basis, but which often raises concern about malignancy and may be radiographically indistinguishable from neuroendocrine tumors, pancreatic tumors, and adenocarcinomas. Therefore, the present study aims to report a case of IPAS using computed tomography (CT) and magnetic resonance (MR) imaging, in addition to correlating the radiographic findings of the case report with other radiological methods in the literature review. Information was obtained by reviewing medical records, conducting interviews with the patient, and using diagnostic photographs and laboratory data. In this context, the case report is of a male patient with previous history of renal cell carcinoma who had undergone total left nephrectomy and resection of retroperitoneal lymph nodes. Post-operative followed-up exams showed a nodular image in the pancreatic tail suggestive of metastasis, but whose correct diagnosis was possible by CT and MR studies as only an asymptomatic benign affection was shown, meaning that only a conservative intervention was necessary (AU).

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Abstract The spleen is supplied by blood flow through the splenic artery and vein. The purpose of this communication is to report an ectopic spleen supplied only by reverse flow through the left gastro-omental vessels. A 14-year-old boy presented with pelvic splenomegaly supplied only by the left gastro-omental artery and veins connected to the inferior polar vessels, which were the only vessels communicating with the spleen. After detorsion of the spleen and splenopexy, the spleen returned to normal dimensions. The patient had uneventful follow-up. In conclusion, the left gastroepiploic vessels are able to maintain the entire spleen blood supply.

Resumo O baço é suprido pelo fluxo sanguíneo da artéria e veia esplênicas. O objetivo desta comunicação é apresentar um baço ectópico suprido apenas pelo fluxo sanguíneo reverso proveniente dos vasos gastromentais esquerdos. Um paciente de 14 anos apresentou esplenomegalia pélvica suprida apenas por artéria e veia gastromentais esquerdas, conectadas aos vasos polares inferiores, que eram os únicos presentes nesse baço. Após a distorção do baço e a esplenopexia, o baço voltou às dimensões normais. Não houve intercorrências no acompanhamento do paciente. Em conclusão, os vasos gastromentais esquerdos são capazes de suprir o fluxo sanguíneo de todo o baço.

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O baço canino exerce diversas funções, dentre elas linfáticas, hematopoiéticas, imunológicas e circulatórias, sendo que suas características morfológicas e funcionais facilitam a ocorrência de lesões neoplásicas e não neoplásicas. Este trabalho tem como objetivo realizar um estudo retrospectivo dos resultados histopatológicos esplênicos, oriundos do Laboratório do Hospital Escola Veterinário do Centro Universitário de Jaguariúna (HEV- UNIFAJ) Jaguary no período de 2015 a 2020. Foram analisadas 44 amostras esplênicas, nos achados histopatológicos 15/44 (34,1%) se tratavam de neoplasias, 28/44 (63,6%) representaram alterações não neoplásicas, enquanto que 1/44 (2,3%) foi diagnosticado como sítio metastático. Levando em consideração a prevalência das alterações não neoplásica, juntamente com as novas abordagens terapêuticas realizadas na medicina humana, a Medicina Veterinária poderia levar em conta tais fatores na elaboração de modernos planejamentos cirúrgicos e atuais escolhas de tratamentos.(AU)

The canine spleen has several functions, including lymphatic, hematopoietic, immunological and circulatory, and its morphological and functional characteristics facilitate the occurrence of neoplastic and non-neoplastic lesions. This work aims to carry out a retrospective study of splenic histopathological results, from the Laboratory of the Veterinary School Hospital of the Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary in the period from 2015 to 2020. 44 splenic samples were analyzed, in the histopathological findings 15 / 44 (34.1%) were neoplasms, 28/44 (63.6%) represented non-neoplastic alterations, while 1/44 (2.3%) was diagnosed as a metastatic site. Taking into account the prevalence of non-neoplastic alterations, together with the new therapeutic approaches in human medicine, Veterinary Medicine could take such factors into account in the elaboration of modern surgical plans and current treatment choices.(AU)

El bazo canino ejerce diversas funciones, entre ellas linfáticas, hematopoyéticas, inmunológicas y circulatorias, siendo que sus características morfológicas y funcionales facilitan la occurencia de lesiones neoplásicas y no neoplásicas. Este trabajo tiene como objetivo realizar un estudio retrospectivo de los resultados histopatológicos esplénicos, oriundos del Laboratorio del Hospital Escuela Veterinaria del Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary en el período de 2015 a 2020. Se analizaron 44 muestras esplénicas, en los hallazgos histopatológicos 15/44 (34,1%) se trataban neoplasias, 28/44 (63,6%) representaron alteraciones no neoplásicas, mientras que 1/44 (2,3%) fue diagnosticado como sitio metastásico. Teniendo en cuenta la prevalencia de las alteraciones no neoplásicas, junto con los nuevos enfoques terapéuticos realizados en la medicina humana, la Medicina Veterinaria podría tener en cuenta tales factores en la elaboración de modernos planes quirúrgicos y actuales opciones de tratamiento.(AU)

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Resumen El bazo es el órgano que se lesiona con más frecuencia en el trauma abdominal cerrado, presentándose en 30 a 50% de los casos, principalmente por su fragilidad y localización, su tratamiento ha estado en constante cambio a lo largo del tiempo, siendo hoy en día más utilizado el manejo conservador por sobre el intervencionista, considerando sobre todo el mayor riesgo de mortalidad y las condiciones fisiológicas posteriores a la esplenectomía principalmente en niños y adolescentes. Objetivo. Realizar una revisión actual del diagnóstico, clasificación y tratamiento del trauma esplénico. Metodología . Se realizó una revisión bibliográfica incluyendo los descriptores relacionados con trauma esplénico y su tratamiento. Resultados. La identificación del trauma esplénico es de vital importancia para la supervivencia del paciente, el diagnostico se puede realizar mediante estudios de imagen eco-FAST o tomografía en dependencia del estado hemodinámico del paciente, la clasificación depende de las características anatómicas de las lesiones y orienta el tratamiento adecuado. Conclusiones. Actualmente el tratamiento conservador está recomendado para lesiones I-III; los estadios mayores (IV y V) o cualquier grado siempre y cuando exista compromiso hemodinámico implican tratamiento intervencionista o quirúrgico, no existe una diferencia significativa entre la utilización de técnica abierta vs laparoscópica.

Abstract The spleen is the organ that is most frequently injured in blunt abdominal trauma, occurring in 30 to 50% of cases, mainly due to its fragility and location, its treatment has been in constant change over time, today the conservative management is more widely used than interventionist, considering above all the greater risk of mortality and the physiological conditions after splenectomy, mainly in children and adolescents. Objective . To carry out a current review of the diagnosis, classification and treatment of splenic trauma. Methodology . A bibliographic review was carried out including the descriptors related to splenic trauma and its treatment. Results .The identification of splenic trauma is of vital importance for the survival of the patient, the diagnosis can be made by imaging studies, FAST ultrasound or tomography depending on the hemodynamic status of the patient, the classification depends on the anatomical characteristics of the lesions and guides the appropriate treatment. Conclusions . Conservative treatment is currently recommended for lesions I-III; the major stages (IV and V) or any grade whit hemodynamic compromise imply interventional or surgical treatment, there is no significant difference between the use of open versus laparoscopic technique.

Resumo O baço é o órgão mais frequentemente lesado no trauma abdominal fechado, ocorrendo em 30 a 50% dos casos, principalmente devido à sua fragilidade e localização, seu tratamento tem mudado constantemente ao longo do tempo, sendo hoje o manejo conservador mais utilizado que o intervencionista, considerando sobretudo o maior risco de mortalidade e as condições fisiológicas após a esplenectomia, principalmente em crianças e adolescentes. Objetivo . Fazer uma revisão atual do diagnóstico, classificação e tratamento do trauma esplênico. Metodologia . Foi realizada uma revisão bibliográfica incluindo os descritores relacionados ao trauma esplênico e seu tratamento. Resultados . A identificação do trauma esplênico é de vital importância para a sobrevida do paciente, o diagnóstico pode ser feito por exames de imagem echo-FAST ou tomografia dependendo do estado hemodinâmico do paciente, a classificação depende das características anatômicas das lesões e orienta o tratamento adequado. Conclusões . O tratamento conservador é atualmente recomendado para lesões I-III; os estágios principais (IV e V) ou em qualquer grau, desde que haja comprometimento hemodinâmico, implicam em tratamento intervencionista ou cirúrgico, não havendo diferença significativa entre o uso da técnica aberta e laparoscópica.

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Background: Liposarcoma is a malignant neoplasm of lipoblasts with low incidence in dogs, representing 1.7% of tumorsdiagnosed in the spleen. In veterinary medicine, this neoplasm is classified morphologically into the myxoid, well-differentiated, undifferentiated and pleomorphic subtypes, the latter being one of the most aggressive forms, mainly in cavityorgans. This report refers to a primary splenic pleomorphic liposarcoma in a female dog, addressing anatomopathologicaland immunohistochemical aspects.Case: A 14-year-old, 35 kg bitch mongrel with history of absence of defecation, progressive weight loss, difficulty walking, sensitivity to abdominal palpation, prostration, pale mucous membranes, tachypnea and abdominal distention waspresented to diagnosis. The condition evolved to death and, on necroscopy, there was an increase in splenic volume withneoformation of whitish and reddish color, measuring 32 × 27 cm in its largest axes and weighing 8.9 kg. The neoformationexhibited areas of firm and soft consistency, and sectioning revealed focal areas of extensive necrosis and cavity collectionsof different diameters that allowed the flow of liquid serous contents with a brownish red color. Microscopy showed cellsof neoplastic morphology infiltrating the splenic parenchyma, mostly with slightly acidophilic cytoplasm and few intracytoplasmic lipid vacuoles, which varied in size and distribution. The nucleus of the cells was large, eccentric and irregular,with round to oval morphology, grossly lacy chromatin and single or multiple evident nucleoli. These cells exhibited markedanisocytosis, anisokaryosis and pleomorphism, with more than one mitotic figure per high magnification field visible. Mildinflammatory infiltrate, predominantly lymphocytic, permeated the neoplastic cells, and marked depletion of lymphoidfollicles and atrophy of the red pulp were found in the remaining splenic parenchyma. Immunohistochemical tests...(AU)

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O baço canino exerce diversas funções, dentre elas linfáticas, hematopoiéticas, imunológicas e circulatórias, sendo que suas características morfológicas e funcionais facilitam a ocorrência de lesões neoplásicas e não neoplásicas. Este trabalho tem como objetivo realizar um estudo retrospectivo dos resultados histopatológicos esplênicos, oriundos do Laboratório do Hospital Escola Veterinário do Centro Universitário de Jaguariúna (HEV- UNIFAJ) – Jaguary no período de 2015 a 2020. Foram analisadas 44 amostras esplênicas, nos achados histopatológicos 15/44 (34,1%) se tratavam de neoplasias, 28/44 (63,6%) representaram alterações não neoplásicas, enquanto que 1/44 (2,3%) foi diagnosticado como sítio metastático. Levando em consideração a prevalência das alterações não neoplásica, juntamente com as novas abordagens terapêuticas realizadas na medicina humana, a Medicina Veterinária poderia levar em conta tais fatores na elaboração de modernos planejamentos cirúrgicos e atuais escolhas de tratamentos.

The canine spleen has several functions, including lymphatic, hematopoietic, immunological and circulatory, and its morphological and functional characteristics facilitate the occurrence of neoplastic and non-neoplastic lesions. This work aims to carry out a retrospective study of splenic histopathological results, from the Laboratory of the Veterinary School Hospital of the Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary in the period from 2015 to 2020. 44 splenic samples were analyzed, in the histopathological findings 15 / 44 (34.1%) were neoplasms, 28/44 (63.6%) represented non-neoplastic alterations, while 1/44 (2.3%) was diagnosed as a metastatic site. Taking into account the prevalence of non-neoplastic alterations, together with the new therapeutic approaches in human medicine, Veterinary Medicine could take such factors into account in the elaboration of modern surgical plans and current treatment choices.

El bazo canino ejerce diversas funciones, entre ellas linfáticas, hematopoyéticas, inmunológicas y circulatorias, siendo que sus características morfológicas y funcionales facilitan la occurencia de lesiones neoplásicas y no neoplásicas. Este trabajo tiene como objetivo realizar un estudio retrospectivo de los resultados histopatológicos esplénicos, oriundos del Laboratorio del Hospital Escuela Veterinaria del Centro Universitário de Jaguariúna (HEV-UNIFAJ) - Jaguary en el período de 2015 a 2020. Se analizaron 44 muestras esplénicas, en los hallazgos histopatológicos 15/44 (34,1%) se trataban neoplasias, 28/44 (63,6%) representaron alteraciones no neoplásicas, mientras que 1/44 (2,3%) fue diagnosticado como sitio metastásico. Teniendo en cuenta la prevalencia de las alteraciones no neoplásicas, junto con los nuevos enfoques terapéuticos realizados en la medicina humana, la Medicina Veterinaria podría tener en cuenta tales factores en la elaboración de modernos planes quirúrgicos y actuales opciones de tratamiento.

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Background: Liposarcoma is a malignant neoplasm of lipoblasts with low incidence in dogs, representing 1.7% of tumorsdiagnosed in the spleen. In veterinary medicine, this neoplasm is classified morphologically into the myxoid, well-differentiated, undifferentiated and pleomorphic subtypes, the latter being one of the most aggressive forms, mainly in cavityorgans. This report refers to a primary splenic pleomorphic liposarcoma in a female dog, addressing anatomopathologicaland immunohistochemical aspects.Case: A 14-year-old, 35 kg bitch mongrel with history of absence of defecation, progressive weight loss, difficulty walking, sensitivity to abdominal palpation, prostration, pale mucous membranes, tachypnea and abdominal distention waspresented to diagnosis. The condition evolved to death and, on necroscopy, there was an increase in splenic volume withneoformation of whitish and reddish color, measuring 32 × 27 cm in its largest axes and weighing 8.9 kg. The neoformationexhibited areas of firm and soft consistency, and sectioning revealed focal areas of extensive necrosis and cavity collectionsof different diameters that allowed the flow of liquid serous contents with a brownish red color. Microscopy showed cellsof neoplastic morphology infiltrating the splenic parenchyma, mostly with slightly acidophilic cytoplasm and few intracytoplasmic lipid vacuoles, which varied in size and distribution. The nucleus of the cells was large, eccentric and irregular,with round to oval morphology, grossly lacy chromatin and single or multiple evident nucleoli. These cells exhibited markedanisocytosis, anisokaryosis and pleomorphism, with more than one mitotic figure per high magnification field visible. Mildinflammatory infiltrate, predominantly lymphocytic, permeated the neoplastic cells, and marked depletion of lymphoidfollicles and atrophy of the red pulp were found in the remaining splenic parenchyma. Immunohistochemical tests...

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ABSTRACT: Myelolipoma is a benign neoplasm composed of mature adipocytes and hematopoietic elements. This tumor is rare in dogs and cats and can develop in several organs and tissues. This report describes a case of splenic myelolipoma in a dog characterizing its clinical-pathological and ultrasonography aspects. A 9-year-old, female, mixed-breed, castrated dog was referred to the veterinary hospital with increased abdominal circumference. Ultrasonography revealed splenomegaly with masses of not measurable dimensions along the entire length of the parenchyma. The spleen was removed, and a fragment was sent for histopathological analysis. Macroscopically, the spleen was enlarged, with irregularly nodular growths that project above the surface of the organ. Nodules were red with small yellow areas. Microscopically, the spleen was effaced by a well-demarcated and not encapsulated mass composed of histologically well-differentiated neoplastic adipose tissue with islands and nests of varying proportions of hematopoietic elements. Histological examination confirmed the diagnosis of myelolipoma. Myelolipomas are observed on ultrasound images as hyperechoic masses or nodules with homogeneous echo texture. Here, ultrasound appearance involved mixed echogenicity and heterogeneous echotexture, due to the mixture of fat and non-fatty material components of the tumor.

RESUMO: Mielolipoma é uma neoplasia composta por adipócitos maduros e elementos hematopoiéticos. Este tumor é raro em cães e gatos e pode se desenvolver em diversos órgãos e tecidos. Descreve-se um caso de mielolipoma esplênico em um cão caracterizando seu aspecto clínico-patológico e ultrassonográfico. Um canino, fêmea, castrada, SRD, de 9 anos de idade foi encaminhada para o Hospital Veterinário com um aumento na circunferência abdominal. A ultrassonografia abdominal revelou esplenomegalia com massas de dimensões imensuráveis em toda a extensão do parênquima. Foi realizada esplenectomia total e um fragmento do baço foi encaminhado para análise histopatológica. Macroscopicamente o baço estava aumentado de tamanho, com crescimentos nodulares irregulares que se projetam acima da superfície do órgão. Os nódulos eram vermelhos com pequenas áreas amarelas. Microscopicamente foi observada uma massa bem demarcada e encapsulada composta por tecido adiposo neoplásico bem diferenciado, com ilhas e ninhos de elementos hematopoiéticos de proporção variada. O diagnóstico foi confirmado pelo exame histopatológico. Mielolipomas são observados nas imagens ultrassonográficas como massas hiperecóicas ou nódulos com ecotextura homogênea. Neste caso, o achado ultrassonográfico mostrou ecogenicidade mista e ecotextura heterogênea, provavelmente devido à mistura dos componentes do tumor com material gorduroso e não gorduroso.

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Background: Splenic stromal neoplasms are a heterogeneous group of tumors that shares the morphology of spindle cells, and are considered a primary mesenchymal neoplasm of the spleen. Among these neoplasms, some are as yet unclassified. Although stromal neoplasms represent 25 a 50% of dog splenic neoplasms in dogs, subtypes rarely occur alone. As these neoplasms are difficult to diagnose in the routine veterinary medical examination, the objective of this article was to report a case of splenic stromal sarcoma in a dog treated at a private veterinary hospital in Recife, Pernambuco, Brazil. Case: An 8-year-old male labrador dog was treated at a veterinary hospital for an initial clinical suspicion of gastroenteritis. Clinical examinations showed anemic ocular mucosa and a distended abdomen. Considering the animal's condition, blood count, serum biochemistry, and abdominal ultrasonography (US) were requested. The laboratory tests revealed anemia, thrombocytopenia, leukocytosis with neutrophilia, and changes in the indices of alanine aminotransferase (ALT) and alkaline phosphatase (ALP), among other findings. Abdominal ultrasound showed hepatomegaly, diffuse splenomegaly, a neoformation in the spleen suggestive of splenic neoplasia, and mild cystic prostatic hyperplasia. The dog underwent exploratory laparotomy with splenectomy. During the procedure, a nodule was found attached to the spleen. It was removed, fixed in a 10% neutral buffered formalin solution, and sent for histopathological and immunohistochemical examinations (vimentin, S100, desmin, MyoD1, HHF35, CD31, and alpha smooth muscle actin). The histopathological diagnosis was poorly differentiated spindle cell splenic sarcoma, compatible with splenic stromal sarcoma. Immunohistochemistry showed neoplastic cells immunoreactive for vimentin and S100, and it was not reactive for other markers. Based on the immunohistochemical and morphological profile, the diagnosis of splenic stromal sarcoma was confirmed. Discussion: Dogs affected by splenic neoplasms are generally aged between three and 17 years, and clinically present with anorexia, emesis, lethargy, weight loss, and abdomen distension, which were observed in the present case. However, a purelyclinical diagnosis is disputable, since other diseases can present the same signs. Thus, complementary exams are essential for a correct diagnosis. Laboratory changes in blood count and serum biochemistry are considered nonspecific for splenic neoplasms, with neutrophilic leukocytosis and anemia being consistent with paraneoplastic syndromes frequently diagnosed in small animals. Microscopically, splenic stromal sarcomas are characterized by focal splenic nodules composed of cohesive polygonal to spindle-shaped cell layers. The cells usually exhibit anisokaryosis and often have large oval to round vesicular nuclei and, occasionally, multinucleated cells. They have large areas of necrosis, diffuse or nodular lymphoid aggregates, and foci of extramedullary hematopoiesis, consistent with the histopathological examination reported in the present case. The immunohistochemical analysis included evaluation of seven markers to elucidate the histogenesis of the neoplasm, with the anti-vimentin and anti-S100 markers demonstrating positive cytoplasmic immunoreactivity, revealing the mesenchymal origin of the neoplasm. Thus, the definitive diagnosis was splenic stromal sarcoma, a rare and aggressive neoplasm.

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