What is this Gross Finding called?
You may have seen this one before…
Although you may have seen this one before, certainly you have if you follow me, because I’ve shown an example before. But let’s have a look and then we can discuss:
Once you see it, you never forget it.
The above pathology is referred to as what?
A. Granulatomous splenitis
B. Hyaline perisplenitis
C. Candy-coated spleen
D. 2 of these are correct
The answer to the quiz question is D. “2 of these are correct”. The technical term (and how I would refer to it in a pathology report) is “hyaline perisplenitis”, but it is also informally known as “candy coated” spleen due to the appearance of it looking like melted sugar or icing. But what is it really?
Hyaline perisplenitis is most often seen in those who have had intraabdominal infections at some point in their lives, and I tend to see it in older people and especially those who have end stage renal disease that requires dialysis. When there is extra fluid in the abdomen (as there often is with these patients), that fluid can be a source of infection. Although we aren’t 100% sure why it causes this exact pattern it is most likely a healing resolution of the surface of the organ (the inside of the spleen looks perfectly normal), in which collagen is laid down as a protective scar like layer. In a way, this appearance is a testament to the effectiveness of the splenic capsule!
—DLW