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Case 1
Emergency splenectomy
A. Faravelli
– Desio Hospital
(Pictures by dr. Faravelli)
Clinical history
A 60 y.o. admitted in the Nephrology Division for chronic renal failure and dialysis, falls from the bed. A diagnosis of hemoperitoneum by suspected spleen rupture is done and the patient undergoes emergency splenectomy.
Macroscopical description
the spleen weighs 1300 grams, has proper form and smooth surface, the consistency is increased. On cut section it has ochre-brownish colour and homogeneous aspect ( Picture 1 - Picture 2).
Microscopical description
Histologically there is nearly complete disappearance of the white pulp and in the red pulp and around the blood vessels there are deposits of homogeneous, eosinophilic material ( Picture 3 - Picture 4 - Picture 5 - Picture 6) which is positive with Congo Red ( Picture 7 - Picture 8) and resistant to the treatment with potassium permanganate. The material is therefore amyloid AL.
Diagnosis
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