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British Journal of Radiology (2009) 82, e67-e71
© 2009 British Institute of Radiology
doi: 10.1259/bjr/66918927
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British Journal of Radiology 82 (2009),e67-e71 ©2009 The British Institute of Radiology

Epstein–Barr virus-positive inflammatory pseudotumour and inflammatory pseudotumour-like follicular dendritic cell tumour

S KIRYU, MD, PhD 1 K TAKEUCHI, MD, PhD 2 J SHIBAHARA, MD, PhD 3 H UOZAKI, MD, PhD 3 M FUKAYAMA, MD, PhD 3 H TANAKA, MD 4 E MAEDA, MD 1 M AKAHANE, MD 1 and K OHTOMO, MD, PhD 1

1 Department of Radiology, Graduate School and Faculty of Medicine, University of Tokyo, 2 Department of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, 3 Department of Pathology, Graduate School and Faculty of Medicine, University of Tokyo, 4 Department of Diagnostic Radiology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan

Correspondence: Shigeru Kiryu, Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. E-mail: kiryu-tky{at}umin.ac.jp

Various splenic inflammatory pseudotumours are reported to be infected with Epstein–Barr virus (EBV), which is thought to be associated with the pathogenesis of the lesion. The term "inflammatory pseudotumour (IPT)-like follicular dendritic cell tumour", all cases of which are also EBV positive, has recently been proposed. Here, we describe the imaging findings of these splenic tumours and present the cases of an IPT-like follicular dendritic cell tumour and two EBV-positive inflammatory pseudotumours in two female patients and one male patient. These splenic lesions were found incidentally on pre-operative or post-operative screening or at medical check-up. CT performed on all three patients revealed low-density solitary masses in the spleen. MRI was performed on one patient; the solitary mass demonstrated isointensity on T1 weighted images and low intensity on T2 weighted images relative to the surrounding splenic parenchyma. Dynamic MRI study revealed that the mass did not enhance on the early phase but enhanced to the same degree as the surrounding splenic parenchyma on the delayed phase. The imaging findings are almost identical to those found in conventional IPT because the morphology is similar in both cases; however, attention should be paid to this new entity in the diagnosis of splenic lesions because of its neoplastic nature. Longer follow-up is also necessary for these patients compared with those with conventional IPT.






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